2934 SGLT-2 INHIBITORS DELAY KIDNEY FAILURE PROGRESSION AND REDUCE NEED OF DIALYSIS IN CHRONIC KIDNEY DISEASE PATIENTS: A META-ANALYSIS

Abstract Background and Aims chronic kidney disease (CKD) is the main complication of type 2 diabetes mellitus (type 2 DM) with up to 7 million cases requiring dialysis therapy. The newest type 2 DM therapy, sodium-glucose co-transporter-2 inhibitor (SGLT-2 inhibitor), has developed into an attractive option for patients with comorbid CKD because of its effect on blood pressure and albuminuria, in addition to its effect on lowering blood sugar. Therefore, we conducted a systematic review and meta-analysis aimed at assessing the effect of SGLT-2 inhibitors in preventing the progression of renal failure and the need for dialysis in CKD patients with and without type 2 DM. Method We performed an analysis of randomized controlled trials of SGLT-2 inhibitors reporting renal outcomes in patients with and without type 2 DM. We searched the PUBMED, MEDLINE, and CENTRAL databases from baseline to August 2022 to identify suitable studies. The major outcome evaluated was the combination of a persistent increase in serum creatinine two times from baseline and the need for dialysis. Results Of the 2890 identified articles, ten studies were included in the inclusion criteria assessing the effect of using SGLT-2 inhibitors. Out of 76,312 participants, 1716 participants experienced a 2-fold increase in serum creatinine, and 647 participants required dialysis. The use of SGLT-2 inhibitors significantly reduced progressive renal failure and the need for dialysis in both patients with type 2 DM (RR: 0.65, 95% CI 0.60–0.71, p = 0.000) and patients without type 2 DM (RR: 0.59, 95% CI 0.46–0.77, p = 0.000). Subgroup analysis also showed that SGLT-2 inhibitors showed a significant effect in the group with eGFR > 60 ml/min (RR: 0.53, 95% CI 0.45-0.62, p = 0.000) and the group with eGFR 30- 60 ml/min (RR:0.66, 95% CI, 0.57-0.75, p = 0.000). Conclusion SGLT-2 inhibitors can significantly inhibit the progression of CKD and reduce the risk of needing dialysis in patients with and without type 2 DM. These effects were shown consistently across groups with varying baseline eGFR values.