Key result
SGLT2 inhibitors linked to improved eGFR trajectory in lithium-treated patients with mood disorders.
Why the study?
Do SGLT2 inhibitors improve eGFR trajectory in patients with mood disorders on long-term lithium therapy?
Cohort
No
Do SGLT2 inhibitors improve eGFR trajectory in patients with mood disorders on long-term lithium therapy?
SGLT2 inhibitors may mitigate lithium-associated kidney dysfunction in patients with mood disorders, improving eGFR trajectories.
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May mitigate lithium nephrotoxicity in mood disorders; extends SGLT2i benefits but leaves causality open pending RCTs.
INTRODUCTION: Sodium-glucose cotransporter-2 inhibitors (SGLT2i), initially developed for type 2 diabetes, have shown promise in improving renal outcomes in patients with and without diabetes. However, their effect on lithium-associated kidney dysfunction remains unknown. METHODS: This historical cohort study included patients from Mayo Clinic (2001-2023) with mood disorders who received lithium for ≥ 6 months and later used SGLT2i for ≥ 1 month. Data on SGLT2i use and lithium treatment were extracted from electronic health records. Serum creatinine values were used to calculate estimated glomerular filtration rate (eGFR) trajectories. Linear mixed-effects models with piecewise linear splines were used to estimate eGFR slopes before and after SGLT2i initiation, adjusted for age and sex. RESULTS: per year, reflecting a + 2.13 change (p = 0.025). Sensitivity analyses, including only patients on lithium at SGLT2i initiation (n = 22) or who had > 1 year of SGLT2i use (n = 29) showed similar, though non-significant, changes in slopes. CONCLUSION: SGLT2i treatment was associated with a significant improvement in eGFR trajectory in patients with mood disorders who received long-term lithium therapy. These findings suggest a potential role for SGLT2is in mitigating lithium-associated kidney dysfunction and highlight the need for randomized controlled trials in this population.
Ercis et al. (2026) conducted a cohort in Mood disorders with lithium-associated kidney dysfunction. SGLT2 inhibitors vs. Before SGLT2i initiation was evaluated on eGFR trajectory (slope) (+ 2.13 change, p=0.025). SGLT2 inhibitor use was associated with a significant improvement in eGFR trajectory (+2.13 change per year, p=0.025) in patients with mood disorders receiving long-term lithium therapy.
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