Abstract

Background: Sodium glucose cotransporter 2 (SGLT2) inhibitor is a standard treatment for kidney and cardiovascular protection in chronic kidney disease (CKD). Recent evidence suggests that SGLT2 inhibitor may enhance erythropoiesis, but data are limited in advanced kidney disease.
Materials and methods: We reviewed 670 CKD patients with diabetes started on SGLT2 inhibitor. Their hemoglobin level and estimated glomerular filtration rate (eGFR) 6 months before the use of SGLT2 inhibitor, immediately before, and 6 months after the use of SGLT2 inhibitor were reviewed.
Results: The hemoglobin level had a small but significant increase 6 months after SGLT2 inhibitor treatment from 12.89 ± 1.75 to 13.08 ± 1.94 g/dL (p < 0.0001). The absolute increase in hemoglobin was 0.19 ± 1.06 g/dL; 117 patients (17.5%) had an increase ≥ 1.0 g/dL. In contrast, the average hemoglobin level was 13.01 ± 1.75 g/dL 6 months before SGLT2 inhibitor, which showed a significant decline to the pre-treatment level (p = 0.001). The increase in hemoglobin after SGLT2 inhibitor was most marked in CKD stage 3b (12.26 ± 1.81 to 12.68 ± 1.98 g/dL, p < 0.0001). There was no significant correlation between the change in hemoglobin level and the severity of pre-treatment albuminuria, eGFR, or HbA1c level, but it had significant correlations with the change in eGFR (r = -0.172, p < 0.0001) and HbA1c (r = 0.120, p = 0.004) during the same period.
Conclusion: SGLT2 inhibitor therapy leads to a small but significant increase in hemoglobin level in patients with diabetes, including those with moderate to severe CKD.

Author Details

Authors

• Chuanlei Li^{1, 2}
• Jack KC Ng¹
• Gordon CK Chan¹
• Winston WS Fung¹
• Kai-Ming Chow¹
• Cheuk-Chun Szeto^{1, 2}

Departments

• ¹ Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, and
• ² Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China

Address

Professor Cheuk-Chun Szeto, MD, FRCP
Department of Medicine & Therapeutics
Prince of Wales Hospital
The Chinese University of Hong Kong
Shatin, NT, Hong Kong, China
Email: [email protected]

Citation