SGLT-2 inhibitors in chronic peritoneal dialysis patients: a follow-up study

Abstract Background Sodium-glucose transporter-2 inhibitors (SGLT-2i) are recommended for use in patients with type 2 diabetes comorbid atherosclerotic cardiovascular disease, heart failure or chronic kidney disease. Limited reports are currently available for their use in dialysis patients. We reported clinical characteristics of chronic peritoneal dialysis (PD) patients on SGLT-2 inhibitors in a follow-up study. Methods We enrolled 50 diabetic chronic PD patients, and 11 continued SGLT-2i after PD treatment. We reported the patients' ultrafiltration, HbA1c, urinary tract infection episodes, and venous CO2 during follow-up and compared the differences in these factors between patients with and without SGLT-2i. Results The mean age of the patients was 65 ± 15 years, and 16 (32%) patients were female. The age, gender, heart failure, and primary kidney disease were not different between patients with and without SGLT-2i at enrollment. In an average of 31 months follow-up, patients with SGLT-2i had a higher ultrafiltration (1322 ± 200 ml/day vs 985 ± 415 ml/day, p = 0.013), hemoglobin (11.2 ± 1.7 vs 10.2 ± 1.7 g/dl), a lower venous CO2 (p = 0.036). The urine amount, the overall survival, the technical survival, and the chance of UTI were not different between patients with and without SGLT2i. Conclusion SGLT-2i may increase ultrafiltration volume and hemoglobin levels in chronic PD patients. The use of SGLT-2i did not increase urinary tract infection but was linked to subclinical metabolic acidosis.