Knowledge, Attitude and Practice in Managing Chronic Kidney Disease with SGLT2 Inhibitors

Abstract

Background and objective: Chronic kidney disease (CKD), and its increasing global burden, is associated with significant morbidity and mortality. This survey-based study aims to capture the knowledge, attitude and practices (KAP) amongst practicing physicians in considering sodium-glucose co-transporter 2 inhibitors (SGLT2i) for the prevention and progression of CKD in diabetic or nondiabeticindividuals. Methodology: An online questionnaire-based survey was conducted among 262 health care practitioners (HCPs) who manage people with CKD with or without diabetes. The survey was prepared as a Google form and circulated through email to different HCPs. The survey consisted of 6 knowledge-based questions, 4 attitude-based questions and 4 practice-based questions. The forms were filled up voluntarily by the participants and the authors had no control over the response provided. All the responses wereconsolidated using Microsoft Excel and analyzed. Results: A total of 262 HCPs from different regions of the country participated in the survey. About 87% to 94% of the participants were aware that SGLT2i, specifically dapagliflozin, is approved for use in CKD patients with or without diabetes. About threefourths of the HCPs accepted that an initial drop in estimated glomerular filtration rate (eGFR) occursupon initiation of dapagliflozin treatment. Almost 90% of them acknowledged the importance of screening for CKD in diabetic patients, and the majority were aware of the renal benefits of SGLT2i. Almost 96% of HCPs consider that dapagliflozin could be used in all patients with CKD irrespective of their diabetes status. Major determining factors with respect to a setback in practice are fear of side effects (54%) and hesitation in switching to newer medications when older medications work fine (34%). Conclusion:SGLT2i have demonstrated significant clinical benefits in patients with CKD with or without diabetes. This survey has shown good awareness among clinicians of the beneficial role of SGLT2i in CKD.