Key result
SGLT2i linked to ~50% higher odds of >10% BNP reduction versus other antidiabetics in DKD.
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Why the study?
Does SGLT2i reduce BNP levels in patients with diabetic kidney disease compared to other antidiabetic drugs?
Observational (n=1,818)
Yes
Does SGLT2i reduce BNP levels in patients with diabetic kidney disease compared to other antidiabetic drugs?
In patients with diabetic kidney disease, SGLT2i initiation is associated with a significantly greater reduction in BNP levels compared to other antidiabetic drugs, suggesting a favorable effect on cardiac stress.
Answers are grounded in this paper and cite their sources.
SGLT2i associated with greater BNP reduction in diabetic kidney disease; hypothesis-generating, prospective trials needed before practice change.
AIMS/INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) prevent cardiovascular events in patients with diabetic kidney disease (DKD). However, limited data exist regarding the change in B-type natriuretic peptide (BNP) after treatment. This study investigated whether SGLT2i are associated with a greater BNP reduction than other antidiabetic drugs and identified the predictors of BNP reduction following SGLT2i. MATERIALS AND METHODS: Using the Japanese nationwide database, we compared BNP levels before and 30-365 days after initiation of antidiabetic medication in 1818 patients with DKD (71 ± 12 years, 68% men, BNP 71 [27-190] pg/mL, estimated glomerular filtration rate (eGFR) 51 ± 22 mL/min/1.73 m RESULTS: BNP reduction, defined as a reduction of >10%, occurred in 474 (50.5%) of 939 patients treated with SGLT2i and 339 (38.6%) of 879 treated with other antidiabetic drugs. SGLT2i was associated with BNP level reduction in a multivariable logistic regression analysis (odds ratio, 1.497 [1.206-1.859]; p < 0.001). This association was consistent across eGFR, proteinuria, and multiple BNP endpoints. Concomitant use of loop diuretics was associated with a lower rate of BNP reduction after SGLT2i. CONCLUSIONS: Compared with other antidiabetic drugs, SGLT2i was substantially associated with BNP reduction in a broad spectrum of DKD.
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Nagahiro et al. (2026) conducted an observational in diabetic kidney disease (n=1,818). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) vs. other antidiabetic drugs was evaluated on BNP reduction >10% (OR 1.497, 95% CI 1.206-1.859, p=< 0.001). SGLT2 inhibitors were associated with a greater likelihood of >10% BNP reduction compared to other antidiabetic drugs in patients with DKD (OR 1.497; 95% CI 1.206-1.859; p<0.001).
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