Do SGLT2 inhibitors affect the risk of acute kidney injury and other adverse events in diverse populations?
While SGLT2 inhibitors provide substantial renoprotective benefits, they may increase the risk of certain nonrenal adverse events, necessitating close monitoring in high-risk patients.
Rationale & Objective: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) provide cardiovascular and renal benefits in individuals with or without type 2 diabetes. This systematic review and meta-analysis investigated the risks of acute kidney injury and other adverse events (AEs) associated with SGLT2is across diverse populations. Study Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Setting & Study Populations: Thirteen RCTs comprising 84,581 participants were included. The studies encompassed diverse populations, varying in diabetes status, presence of chronic kidney disease, and SGLT2i dosages. Selection Criteria for Studies: We included RCTs published through December 31, 2023, that evaluated the safety and efficacy of SGLT2is and reported renal and nonrenal adverse outcomes. Data Extraction: Two reviewers independently extracted data and resolved discrepancies by consensus, focusing on renal and nonrenal AEs and subgroup analyses. Analytical Approach: statistic. Results: = 0.07). Limitations: Variability in study design, definitions of AEs, and patient baseline characteristics may influence the findings. Conclusions: SGLT2is conferred substantial renoprotective benefits but increases the risk of certain nonrenal AEs. Tailored treatment and close monitoring are crucial to ensure safety and efficacy, especially in high-risk patients.
Chiang et al. (Thu,) studied this question.