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Acute kidney injury and adverse renal events in patients receiving SGLT2-inhibitors: A systematic review and meta-analysis

PLoS Medicine Dec 19, 2019

Menne J, et al. - Given the positive effect of sodium-glucose cotransporter-2 inhibitors (SGLT2is: a new class of oral hypoglycemic agents used in the treatment of type 2 diabetes mellitus) on the progression of chronic kidney disease, researchers examined if these cause acute kidney injury. Conducting a database search, they recognized 112 randomized trials relevant for this work. Acute kidney injury in a total of 68,159 patients was reported in 41 of these randomized trials. The analysis revealed 25% lower odds for this adverse effect among patients receiving SGLT2is. In 5 observational (nonrandomized) cohorts reporting on 83,934 patients, patients taking SGLT2is exhibited 60% fewer odds of acute kidney injury. Hypovolemia (fluid depletion) was reported in 92 randomized studies with 81,763 patients (fluid depletion); patients not taking SGLT2is more frequently had hypovolemia, with 20% higher odds. Findings do not suggest that patients taking SGLT2is are at increased risk of acute kidney injury. While lower odds of suffering an acute kidney injury were noted among patients taking SGLT2is than those who did not, despite the fact that these drugs increase fluid loss by the body.
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