{
  "abstract": "Background/Objectives: Early changes in estimated glomerular filtration rate (eGFR) after sodium–glucose cotransporter 2 (SGLT2) inhibitor initiation in heart failure (HF) are difficult to interpret in routine practice. We assessed the clinical correlates of >10% early relative eGFR decline and the subsequent trajectories relative to the pretreatment eGFR. Methods: This retrospective single-center study included 295 patients with HF who remained on SGLT2 inhibitor treatment at their first eligible creatinine assessment on days 10–45 (median 25 days [IQR 21–30]; range 10–42). Multivariable regression, mixed-effects modeling, and within-patient paired analyses were used. Results: Among the 333 initiation episodes, 33 (9.9%) were excluded after early treatment discontinuation, and five repeat episodes were removed. Early decline >10% occurred in 110/295 patients (37.3%). Age ≥ 80 years (adjusted OR 2.14, 95% CI 1.21–3.81), female sex (2.51, 1.42–4.44), higher baseline eGFR per 10 mL/min/1.73 m2 (1.43, 1.21–1.69), and loop-diuretic use (1.82, 1.03–3.23) were associated with decline; the loop-diuretic association attenuated in an expanded model. Twelve-month eGFR was available for 195/295 patients (66.1%). Among the 71 with >10% early decline and paired 12-month data, the mean eGFR increased by 4.70 mL/min/1.73 m2 from the early assessment but remained 6.99 mL/min/1.73 m2 below the pretreatment (both p < 0.001). Conclusions: In this selected cohort, a mean increase after early decline did not indicate a return to the pretreatment mean. The interpretation of an isolated early eGFR value requires clinical context and subsequent measurements.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Aichi Medical University, Nagakute 480-1195, Aichi, Japan",
    "Department of Cardiology, Nagoya Heart Center, Nagoya 461-0045, Aichi, Japan",
    "Department of Cardiology, Toyohashi Heart Center, Toyohashi 441-8530, Aichi, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yoriyasu Suzuki",
      "orcid": "0000-0001-7979-9393"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomohiro Onishi"
    },
    {
      "affs": [
        0
      ],
      "name": "Yusuke Nakano",
      "orcid": "0000-0002-9314-3427"
    },
    {
      "affs": [
        0
      ],
      "name": "Masahiro Shimoda"
    },
    {
      "affs": [
        0
      ],
      "name": "Reiji Goto"
    },
    {
      "affs": [
        2
      ],
      "name": "Takahiko Suzuki"
    },
    {
      "affs": [
        0
      ],
      "name": "Tetsuya Amano"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6pvvkbbs187n8.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208158",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706587/?tool=EBI",
  "id": "6pvvkbbs187n8",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8158",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Heart Failure Treatment and Management"
    ]
  ],
  "openalex": "W7223020156",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706587/pdf/?tool=EBI",
  "pmcid": "PMC13706587",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/6pvvkbbs187n8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208158",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8158"
    },
    {
      "first_seen": "2026-10-30T12:21:44Z",
      "native_id": "PMC:PMC13706587",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13706587"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Heart Failure Treatment and Management",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Early Relative eGFR Decline After SGLT2 Inhibitor Initiation in Heart Failure: Clinical Correlates and Pretreatment-Anchored 12-Month Trajectories",
  "title_text": "Early Relative eGFR Decline After SGLT2 Inhibitor Initiation in Heart Failure: Clinical Correlates and Pretreatment-Anchored 12-Month Trajectories",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:44Z",
  "url": "https://research.draconitic.com/paper/6pvvkbbs187n8",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}