MON-LB032 Real World Evidence Data on the Role of Sodium/Glucose Cotransporter 2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonist in Chronic Kidney Disease Stage 3 Patients beyond Glycemic Control, at Glycemia Clinic- Kuwait

Introduction Diabetes remain the most common reason for progression to end stage renal disease. Chronic kidney disease (CKD) is a strong prediction of mortality in patients with diabetes.(1) Up to 40% of type two diabetes (T2D) will eventually suffer from kidney failure.(2) Sodium/glucose Cotransporter 2 inhibitors (SGLT2) regularly cause a reduction in Glomerular filtration rate (eGFR) by around 5ml/min/1.73 m(2) as well as a reduction in urine microalbumin by 30%-40%.(3) SGLT2 inhibitors are also associated with reduction in uric acid and weight. Both high levels of uric acid and obesity are risk factors for diabetic nephropathy and progression of CKD.(4) While it was found that studies used Glucagon-like Peptide-1 Receptor Agonist (GLP-1 RA) in patients with higher degree of renal impairment was very limited. However, GLP-1 RA was associated with a urine microalbumin and Hba1c reduction.(5) Efficacy of SGLT2 and GLP-1 RA is well documented, though SGLT2 is contraindicated with an eGFR <60 ml/min/1.73 m(2) due to lower efficacy on HbA1c reduction. There is little clinical evidence available up to date showing the benefit of using SGLT2 in CKD stage 3 and above, and may be beneficial in improving different renal outcome. More data is coming for other indication use of SGLT2 in CKD patients with lower eGFR (eGFR <60 ml/min/1.73 m(2)) Methods A retrospective case study was done on 30 patients who attended Glycemia Clinic in Kuwait for better glycemic control. Patients were given different treatments, some of them were on a once GLP-1 RA, dosage between 0.6 up to 3mg/day, some were on SGLT2 inhibitors, where the rest were on a combination of the two medication in addition to other medication to control their glycemic level. Results Nine patients were on GLP-1 RA, six patients were on SGLT2 and fifteen patients were on a combination of both. Patients who were on GLP-1 RA vs. SGLT2 respectively, showed an average improvement in: - eGFR by 16.5 ml/min/1.73m(2) vs. 11.7 ml/min/1.73m(2) - Hba1c by 2.3% vs. 2.1% - Urine Microalbumin 51.6 mg/L vs. 63.9 mg/L Similar results shown on 15 patients who were on a combination treatment of SGLT2 and GLP-1 RA. Conclusion SGLT2 and GLP-1 seems to be safe and have beneficial effect on eGFR and Urine microalbumin in advanced CKD stages. More research may be needed to study the effect of GLP-1 RA and SGLT2 on CKD patients with higher degree of renal impairment. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.