The association between sodium–glucose cotransporter 2 inhibitors and contrast-associated acute kidney injury in patients with type 2 diabetes undergoing angiography: a propensity-matched study

• Published in: European journal of medical research Vol. 29; no. 1; pp. 621 - 11
• Main Authors: Yang, Hao, Yang, Lili, Jardine, Meg J., Arnott, Clare, Neuen, Brendon L., Xu, Kexi, Zhao, Xiaohui, Qian, Dehui, Cui, Bin, Qiu, Youzhu, Huang, Yuli, Yu, Jie, Wang, Jiang, Yu, Shiyong, Tan, Hu, Huang, Lan, Li, Jing-Wei, Jin, Jun
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24.12.2024; BioMed Central; BMC
• Subjects: Acute Kidney Injury - chemically induced; Aged; Analysis; Angiography; Care and treatment; China - epidemiology; Complications and side effects; Contrast Media - adverse effects; Contrast-associated acute kidney injury; Coronary angiography; Coronary Angiography - adverse effects; Coronary Angiography - methods; Creatinine - blood; Dapagliflozin; Dextrose; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetics; Female; Glucose; Humans; Incidence; Male; Middle Aged; Percutaneous coronary intervention; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Propensity Score; Retrospective Studies; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Sodium–glucose cotransporter 2 inhibitor; Transluminal angioplasty; Type 2 diabetes; China; California; Coronary angiography; Contrast-associated acute kidney injury; Percutaneous coronary intervention; Diabetes mellitus; Sodium–glucose cotransporter 2 inhibitor
• DOI: 10.1186/s40001-024-02214-7
• ISSN: 2047-783X; 0949-2321

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been proven to prevent decline in kidney function and failure. Whether SGLT2i affect the risk of contrast-associated acute kidney injury (CA-AKI) remains uncertain. Use of SGLT2i was assessed in consecutive diabetics undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) from January 2020 to May 2023 at a tertiary hospital in Chongqing, China. Propensity-matched analysis was used to adjust for baseline variables. CA-AKI was defined by the Acute Kidney Injury Network (AKIN) as creatinine increase ≥ 0.3 mg/dl (26.4 μmol/l), or a percentage increase in the serum creatinine level of ≥ 50%. A total of 604 new users of SGLT2i, and 298 chronic users of SGLT2i were matched with non-users. New use of SGLT2i was not associated with an increased incidence of AKIN-defined CA-AKI (OR 1.60; 95% CI 0.97-2.63; p = 0.065), in-hospital new-onset dialysis (OR 0.50; 95% CI 0.09-2.73; p = 0.422), or death (OR 0.55; 95% CI 0.18-1.66; p = 0.289). However, it was associated with a minor (> 25%) creatinine elevation (OR 1.55; 95% CI 1.04-2.30; p = 0.030), a 0.3 mg/dl increase in creatinine (OR 1.66; 95% CI 1.01-2.75; p = 0.048), and CMSC-defined CA-AKI (OR 1.51; 95% CI 1.02-2.24; p = 0.039). By 90 days, there was no evidence creatinine elevation differed between the two groups (p = 0.590). Chronic use of SGLT2i was not associated with AKIN-defined CA-AKI (OR, 0.92; 95% CI 0.41-2.05; p = 0.838). New use of SGLT2i during CA or PCI was not associated with an AKIN-defined CA-AKI, and it did not translate into new-onset dialysis or death during hospital stay. Chronic usage of SGLT2i did not affect creatinine. Further randomized clinical trials are warranted to confirm this finding.