The Effects of SGLT-2 Inhibitors on Biochemical Parameters, Kidney Function, and Adverse Events in Elderly Patients with Diabetes Mellitus and Chronic Kidney Disease: A Retrospective Single-Center Study

INTRODUCTION: SGLT2 inhibitors (SGLT2i) have multiple metabolic benefits, including reducing glycated hemoglobin, weight, and blood pressure. Additionally, there are strong renoprotective effects in selected populations. The aim of our study was to investigate changes in biochemical parameters, incidence of complications, and associated factors following SGLT2i use in elderly patients.
METHODS: The study population comprised patients aged 60 years and older who were treated with SGLT2i. The clinical and biochemical data were subjected to analysis at the baseline, six-month, and twelve-month marks following the commencement of treatment. The incidence of complications was evaluated.
RESULTS: A total of 64 patients were included in the analysis, with 54.7% of them being female and an average age of 66.8±5.6 years. Significant reductions in blood pressure, HbA1c, estimated glomerular filtration rate (eGFR), and proteinuria were observed after treatment. Conversely, there was a notable increase in serum magnesium and phosphorus levels. The eGFR exhibited a decline of 3.7 mL/min at the six-month mark, which subsequently slowed to a decrease of 2.4 mL/min at the twelve-month interval. Four patients developed acute kidney injury (AKI), and seven patients experienced urinary tract infections (UTIs) after treatment. The most significant factor associated with the occurrence of side effects was identified as high CRP levels (OR: 1.261; p=0.024).
DISCUSSION AND CONCLUSION: The findings of our study indicate that SGLT2i are effective in improving glycemic control, blood pressure, and proteinuria in elderly patients. It is noteworthy that patients with elevated CRP levels prior to treatment experienced a higher incidence of side effects, indicating that such patients may require closer monitoring.

Keywords: Acute kidney injury, C-reactive protein, chronic kidney disease, diabetes mellitus, sodium-glucose co-transporter 2 inhibitors, urinary tract infections