Retrospective study evaluates renal safety of SGLT-2 inhibitors and glycemic control in diabetic patients undergoing coronary angiography, suggesting safety during cardiac procedures.
Background: Contrast-induced nephropathy (CIN) is a common complication after coronary angiography (CAG), especially in patients with diabetes. Sodium–glucose cotransporter-2 (SGLT-2) inhibitors are well known for their cardio–renal protective effects, but their impact on CIN remains unclear. This study aimed to evaluate the renal safety of SGLT-2 inhibitors in patients undergoing CAG and to examine the role of glycemic control in the risk of CIN. Methods: This retrospective study included 270 patients with type 2 diabetes who underwent elective or urgent CAG. Patients were divided into SGLT-2 users (n = 127) or non-users (n = 143). Demographic characteristics, comorbidities, laboratory data, and antidiabetic therapies were collected. CIN was defined as a ≥25% or ≥0.5 mg/dL increase in serum creatinine within 48 hours after contrast exposure. Hemoglobin A1c (HbA1c) categories were used to perform subgroup analyses. Results: The incidence of CIN was similar between SGLT-2 inhibitor users and non-users (18.1% vs. 14.7%; p = 0.447). Patients administered SGLT-2 inhibitors had higher HbA1c but lower uric acid levels. Overall, renal function decline was more evident in patients with HbA1c >6.4%; however, SGLT-2 inhibitor users showed a milder decrease in estimated glomerular filtration rate (eGFR). The frequent use of metformin and insulin may also influence CIN outcomes. Conclusions: SGLT-2 inhibitors appear to be safe during CAG and may reduce the risk of CIN in patients with poorly controlled diabetes. Larger prospective studies are required to confirm these findings.
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Adıyaman et al. (2026) studied this question.