Sodium-Glucose Cotransporter 2 Inhibitors Lower Mortality and Renal Risks in Adults Aged 80 and Older with Chronic Kidney Disease
Sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduce mortality and the risk of major adverse kidney events in adults aged 80 years and older diagnosed with chronic kidney disease (CKD), according to research presented at Kidney Week, the annual meeting of the American Society of Nephrology held from October 21 to 25 in Denver, Medical Xpress reported. The study examined data from 23,765 matched users and nonusers of the medication to evaluate real-world outcomes in a vulnerable patient population typically excluded from clinical trials.
Real-World Analysis of 23,765 Patients
Led by Julian Doricic, M.D., from Medizinische Hochschule Hannover in Germany, researchers utilized the TriNetX database to identify patients aged 80 and older with chronic kidney disease. The study team used propensity score-matching to account for comorbidities, laboratory parameters, and frailty-associated factors across 23,765 SGLT2 inhibitor users and nonusers. After two years of follow-up, patients treated with the therapy showed an adjusted hazard ratio (aHR) of 0.734 for mortality, demonstrating a significant reduction in death rates that remained consistent across all predefined subgroups.
Cardiovascular and Renal Outcomes in Older Adults
Beyond all-cause mortality benefits, the analysis tracked specific organ-system endpoints over the two-year monitoring period. SGLT2 inhibitor users experienced a lower risk of major adverse cardiovascular events, yielding an adjusted hazard ratio of 0.884. The therapy also yielded protective renal outcomes, with an adjusted hazard ratio of 0.775 for major adverse kidney events.
Very elderly individuals are historically underrepresented in or systematically excluded from large-scale randomized controlled trials due to multimorbidity and frailty.
By leveraging real-world data, our research addresses a crucial blind spot in current medical literature,
co-author Bernhard M.W. Schmidt, M.D., from Hannover Medical School in Germany, said in a statement. Schmidt emphasized that despite the observed survival and renal advantages, physicians must approach treatment carefully. These patients require a careful, individualized risk-benefit assessment and close clinical monitoring,
he said.