Data comparing kidney outcomes between individual sodium-glucose cotransporter-2 (SGLT2) inhibitors are limited. Here, we aimed to compare the subsequent risk of developing kidney outcomes between individual inhibitors. This would be the first study to compare kidney outcomes of patients with diabetes mellitus who were newly treated with individual SGLT2 inhibitors using a large-scale real-world dataset. To do this, we analyzed results from 12,100 patients with diabetes mellitus who were taking different SGLT2 inhibitors (2,573 with empagliflozin; 2,214 with dapagliflozin; 2,100 with canagliflozin; and 5,213 with other such inhibitors). The primary outcome was the rate of estimated glomerular filtration rate (eGFR) decline as assessed using a linear mixed-effects model with an unstructured covariance. The median age of the patients was 53 years, and 84.4% of the patients were men. The median fasting plasma glucose and HbA1c levels were 147 (interquartile range 126–178) mg/dL and 7.5 (6.9–8.4)%, respectively. The median eGFR was 78 mL/min/1.73 m² (interquartile range 68–90). The mean follow-up period was 773 days. The annual eGFR slopes of empagliflozin, dapagliflozin, canagliflozin, and other SGLT2 inhibitors were -1.15 (95% confidence interval, -1.33 to -0.96), -1.14 (-1.32 to -0.96), -1.24 (-1.44 to -1.04), and -1.06 (-1.18 to -0.94) ml/min/1.73 m², respectively. No significant interaction was detected between the SGLT2 inhibitors and time using a linear mixed-effects model. A multitude of sensitivity analyses confirmed the robustness of our primary results. Thus, we found that there was no significant difference in the annual eGFR decline slopes between patients taking different SGLT2 inhibitors.

比较单个钠-葡萄糖协同转运蛋白 2 (SGLT2) 抑制剂之间肾脏结局的数据有限。在这里，我们的目的是比较单个抑制剂之间发生肾脏后果的后续风险。这将是第一项使用大规模真实世界数据集比较新接受个体 SGLT2 抑制剂治疗的糖尿病患者肾脏结局的研究。为此，我们分析了 12,100 名服用不同 SGLT2 抑制剂的糖尿病患者的结果（2,573 名服用恩格列净；2,214 名服用达格列净；2,100 名服用卡格列净； 5,213名服用其他此类抑制剂）。主要结果是估计的比率使用具有非结构化协方差的线性混合效应模型评估肾小球滤过率 (eGFR) 下降。患者的中位年龄为 53 岁，84.4% 的患者为男性。中位空腹血糖和HbA1c 水平分别为 147（四分位数范围 126–178）mg/dL 和 7.5 (6.9–8.4)%。中位 eGFR 为 78 mL/min/1.73 m²（四分位数间距 68–90）。平均随访期为 773 天。恩格列净、达格列净、卡格列净和其他 SGLT2 抑制剂的年度 eGFR 斜率分别为 -1.15（95% 置信区间，-1.33 至 -0.96）、-1.14（-1.32 至 -0.96）、-1.24（-1.44 至 -1.04）和 -1.06（-1.18 至 -0.94）ml/min/1.73 m²， 分别。使用线性混合效应模型未检测到 SGLT2 抑制剂与时间之间存在显着相互作用。大量的敏感性分析证实了我们的主要结果的稳健性。因此，我们发现服用不同 SGLT2 抑制剂的患者的年度 eGFR 下降斜率没有显着差异。