874-P: Effect on Renal Function of SGLT2i Treatment in Hospitalized Patients with Type 2 Diabetes—A Real-World Study

Abstract

Background: SGLT2-I use is expanding greatly; however, temporary treatment hold is recommended in high risk states for kidney failure. Hospitalization is often associated with such risk, so the present study aimed to evaluate the effect on kidney function of SGLT2-I treatment in-hospital. Methods: This retrospective case-control study conducted in internal medicine patients included only those treated with SGLT2-I for >24 hours, and creatinine level was tested up to 48 hours before the start of treatment and after the end. Change in renal function was determined per eGFR (CKD-EPI formula). Factors most influencing in-hospital renal function were identified using backward regression. Results: Among 186 patients included, 66.7% (124) were male, mean age 66.4±8.3 years. Main reasons for hospitalization were atherosclerotic CVD 23.7% (44), heart failure 17.2% (32), and infectious disease 15.6% (29). Median in-hospital SGLT2-I use was three days (interquartile range 2-5 days) and 73.1% (144) received SGLT2-I before hospitalization. Prior eGFR was not low in most participants: in 65.1% (121) >60 ml/min/1.73 m2, and in only 13.4% <45. A high correlation was found between eGFR before and after treatment (r=0.8, p<0.001), with no drop in eGFR for the majority; however in 21% (39) it declined >10%, in 11.3% (21) >20%, in 4.8% (9) >30%, and in only 2.7% (5) >40%. The following factors were found to be significantly associated with a decrease in eGFR both >20% and >30%, including in-hospital initiation of SGLT2-I, in-hospital furosemide treatment, a background of insulin treatment, and age >70 years. In 93 patients treated with SGLT2-I prior to hospitalization and who did not receive in-hospital furosemide, none had a drop in eGFR >30% and only two >20%. Summary: In-hospital SGLT-2 treatment in type 2 diabetes is likely very safe from a renal standpoint in those treated pre-admission with SGLT2-I and not receiving furosemide. Disclosure A.Bashkin: None. E.Kruzel-davila: None. I.Tzfoni: None.