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Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a common complication of patients undergoing percutaneous coronary intervention (PCI). Data regarding the influence of sodium-glucose cotransporter-2 (SGLT2) inhibitor on the CI-AKI incidence and renal outcomes of patients undergoing PCI a...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251334/ https://www.ncbi.nlm.nih.gov/pubmed/35795364 http://dx.doi.org/10.3389/fcvm.2022.918167 |
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author | Hua, Rui Ding, Ning Guo, Hanqing Wu, Yue Yuan, Zuyi Li, Ting |
author_facet | Hua, Rui Ding, Ning Guo, Hanqing Wu, Yue Yuan, Zuyi Li, Ting |
author_sort | Hua, Rui |
collection | PubMed |
description | BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a common complication of patients undergoing percutaneous coronary intervention (PCI). Data regarding the influence of sodium-glucose cotransporter-2 (SGLT2) inhibitor on the CI-AKI incidence and renal outcomes of patients undergoing PCI are limited. This study aimed to examine the real-world risk of CI-AKI in SGLT2 inhibitor users undergoing PCI. METHODS: We used longitudinal data from the medical records of the First Affiliated Hospital of Xi'an Jiaotong University. We selected SGLT inhibitor users and nonusers [patients with type 2 diabetes (T2D) without SGLT2 inhibitor prescription] undergoing PCI. We determined CI-AKI by the ESUR (European Society of Urogenital Radiology, AKI(ESUR)) and KDIGO definition (Kidney Disease: Improving Global Outcomes, AKI(KDIGO)). We performed 1:1 nearest-neighbor propensity matching and calculated unadjusted odds ratios (ORs) and adjusted ORs (aORs; accounting for covariates poorly balanced) for AKI in primary and sensitivity analyses. We compared the renal function indicators in users and nonusers at 24, 48, and 72 h post-PCI. RESULTS: We identified 242 SGLT2 inhibitor users and 242 nonusers in the cohort. The unadjusted ORs of CI-AKI(ESUR) were 63% lower in users [OR: 0.37 (95% CI: 0.18–0.68); P = 0.01], which was unchanged [aOR: 0.37 (95% CI: 0.19–0.67); P < 0.01] post adjustment. These estimates did not qualitatively change across several sensitivity analyses. There was no significant difference in urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) values between the two groups before PCI, and at 24 h, while the creatinine (48 and 72 h post-PCI) and CyC (24 and 48 h post-PCI) were significantly lower than those in the nonuser group (P < 0.05). CONCLUSION: Our findings do not suggest an increased risk of CI-AKI associated with SGLT2 inhibitor use in patients with CAD and T2D undergoing PCI. |
format | Online Article Text |
id | pubmed-9251334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92513342022-07-05 Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis Hua, Rui Ding, Ning Guo, Hanqing Wu, Yue Yuan, Zuyi Li, Ting Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a common complication of patients undergoing percutaneous coronary intervention (PCI). Data regarding the influence of sodium-glucose cotransporter-2 (SGLT2) inhibitor on the CI-AKI incidence and renal outcomes of patients undergoing PCI are limited. This study aimed to examine the real-world risk of CI-AKI in SGLT2 inhibitor users undergoing PCI. METHODS: We used longitudinal data from the medical records of the First Affiliated Hospital of Xi'an Jiaotong University. We selected SGLT inhibitor users and nonusers [patients with type 2 diabetes (T2D) without SGLT2 inhibitor prescription] undergoing PCI. We determined CI-AKI by the ESUR (European Society of Urogenital Radiology, AKI(ESUR)) and KDIGO definition (Kidney Disease: Improving Global Outcomes, AKI(KDIGO)). We performed 1:1 nearest-neighbor propensity matching and calculated unadjusted odds ratios (ORs) and adjusted ORs (aORs; accounting for covariates poorly balanced) for AKI in primary and sensitivity analyses. We compared the renal function indicators in users and nonusers at 24, 48, and 72 h post-PCI. RESULTS: We identified 242 SGLT2 inhibitor users and 242 nonusers in the cohort. The unadjusted ORs of CI-AKI(ESUR) were 63% lower in users [OR: 0.37 (95% CI: 0.18–0.68); P = 0.01], which was unchanged [aOR: 0.37 (95% CI: 0.19–0.67); P < 0.01] post adjustment. These estimates did not qualitatively change across several sensitivity analyses. There was no significant difference in urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) values between the two groups before PCI, and at 24 h, while the creatinine (48 and 72 h post-PCI) and CyC (24 and 48 h post-PCI) were significantly lower than those in the nonuser group (P < 0.05). CONCLUSION: Our findings do not suggest an increased risk of CI-AKI associated with SGLT2 inhibitor use in patients with CAD and T2D undergoing PCI. Frontiers Media S.A. 2022-06-20 /pmc/articles/PMC9251334/ /pubmed/35795364 http://dx.doi.org/10.3389/fcvm.2022.918167 Text en Copyright © 2022 Hua, Ding, Guo, Wu, Yuan and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Hua, Rui Ding, Ning Guo, Hanqing Wu, Yue Yuan, Zuyi Li, Ting Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis |
title | Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis |
title_full | Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis |
title_fullStr | Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis |
title_full_unstemmed | Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis |
title_short | Contrast-Induced Acute Kidney Injury in Patients on SGLT2 Inhibitors Undergoing Percutaneous Coronary Interventions: A Propensity-Matched Analysis |
title_sort | contrast-induced acute kidney injury in patients on sglt2 inhibitors undergoing percutaneous coronary interventions: a propensity-matched analysis |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251334/ https://www.ncbi.nlm.nih.gov/pubmed/35795364 http://dx.doi.org/10.3389/fcvm.2022.918167 |
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