The Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Slowing the Progression of Diabetes Patients with Stage 3-5 Chronic Kidney Disease

Abstract

In managing chronic kidney disease patients, it is recommended to consider using SGLT-2 inhibitors with the aim of reducing urinary protein levels and slowing kidney disease progression in diabetic patients with chronic kidney disease. SGLT-2 inhibitors are a new class of drugs that can reduce urinary albumin levels and slow kidney disease progression, but most studies have been conducted in foreign countries.This research had objective of investigating the effects of SGLT-2 inhibitors on estimated glomerular filtration rate (eGFR) and urinary protein-to-creatinine ratio (UPCR) in patients with type 2 diabetes mellitus with chronic kidney disease, with the aim to compare the effects of SGLT-2 inhibitors on estimated glomerular filtration rate (eGFR) and urinary protein-to-creatinine ratio (UPCR) in patients with type 2 diabetes mellitus and chronic kidney disease with eGFR between 20 and 59 mL/min/1.73 m2. Data including baseline demographics, laboratory findings, and prescriptions, were collected from electronic medical records of Somdejphrajaotaksinmaharaj Hospital from January 2022 to December 2024. Statistical analyses were performed using Chi-square or Independent t-tests. The results found the study involved 260 patients divided into two groups: one receiving SGLT-2 inhibitors and the other not, with 130 individuals in each group. The findings at the end of the study revealed that the average eGFR in the group receiving SGLT-2 inhibitors was significantly higher than that in the group not receiving the inhibitors (40.26±21.08 mL/min/1.73 m² vs. 35.74±14.18 mL/min/1.73 m², p<=0.05). Similarly, the average UPCR in the group receiving SGLT-2 inhibitors was significantly lower than that in the group not receiving SGLT-2 inhibitors (2.23±1.87 mg/mg vs. 2.98±2.56 mg/mg, p<0.05). In patients with type 2 diabetes and chronic kidney disease, continuous treatment with SGLT-2 inhibitors for at least two years was associated with a significant slowing of kidney disease progression and a reduction in urinary protein levels.