Prescribing Patterns for Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Chronic Kidney Disease: Retrospective Analysis at an Academic Family Medicine Center

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated significant renal and cardiovascular benefits in patients with chronic kidney disease (CKD), yet their prescribing rates remain low, particularly in patients without diabetes. This retrospective, single-center study analyzed 358 non-dialysis CKD patients to identify factors associated with SGLT2i use. Of these, 49% received an SGLT2i prescription, with prescribing more common in those with diabetes, heart failure, or existing cardiovascular disease. Multivariate analysis revealed that heart failure, renin-angiotensin system inhibitor use, insulin, and GLP-1 agonists were independently associated with increased SGLT2i prescribing, while prior stroke was linked to lower use. These findings suggest that SGLT2i are primarily prescribed for their cardiovascular and metabolic benefits rather than their renal-protective effects. Targeted efforts to enhance provider awareness of CKD-specific guideline recommendations may help bridge this gap and optimize outcomes for patients with CKD.