Effects of Sodium-Glucose Cotransporter Type 2 Inhibitors on Residual Kidney Function in Patients Undergoing Incremental Hemodialysis: A Two-Center, Retrospective, Exploratory Cohort Study.
12 affiliations
- 1Department of Nephrology, Hospital Central de la Defensa Gómez Ulla, 28047 Madrid, Spain.
- 2Doctoral Program in Health Sciences, Doctoral School, University of Alcalá (UAH), 28805 Madrid, Spain.
- 3Department of Medicine and Medical Specialties, University of Alcalá (UAH), 28805 Madrid, Spain.
- 4Department of Nephrology, Hospital Santa Bárbara, 42003 Soria, Spain.
- 5Department of Nephrology, Hospital General de Fuerteventura, 35600 Fuerteventura, Spain.
- 6Department of Nephrology, Hospital Nuestra Señora de Sonsoles, 05004 Ávila, Spain.
- 7Surgery Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain.
- 8Department of Nephrology, Doctor Negrin University Hospital of Gran Canaria, 35010 Las Palmas de Gran Canaria, Spain.
- 9Department of Medicine, Fernando Pessoa Canarias University, 35450 Las Palmas de Gran Canaria, Spain.
- 10Department of Nephrology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain.
- 11Department of Nephrology, San Pedro de Alcantara Hospital, 10001 Cáceres, Spain.
- 12Department of Nephrology, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain.
Abstract
Background and Objectives: The preservation of residual kidney function (RKF) is a major determinant of outcome in patients undergoing incremental hemodialysis (iHD). While sodium-glucose cotransporter-2 (SGLT-2) inhibitors have established nephroprotective benefits in non-dialysis chronic kidney disease (CKD), evidence regarding their role in preserving RKF after the initiation of hemodialysis remains limited. The primary objective of this study was to explore the impact of SGLT-2 inhibitors on the preservation of RKF in incident patients undergoing iHD over a 12-month follow-up. Materials and Methods: This study involved a two-center retrospective exploratory observational longitudinal study over 12 months of follow-up, including 32 incident iHD patients (one or two sessions per week, 1WHD or 2WHD). Participants were divided into a study group (SGLT-2iG, n = 15) receiving SGLT-2 inhibitors and a control group (non-SGLT-2iG, n = 17). RKF parameters, including 24 h (h) urine output (UO), urea clearance (KrU), and creatinine clearance (CrCl), were monitored quarterly. Results: Over 12 months, 24 h UO increased significantly within the SGLT-2iG (+573.3 mL; p < 0.001) and did not change significantly within controls (-202.9 mL, p = 0.34). KrU and CrCl showed only non-significant within-group trends (upward in the SGLT-2iG, downward in controls). Between-group differences were not formally tested and are described descriptively. A total of 80% of patients in SGLT-2iG maintained a 1WHD regimen at 12 months, compared with 46.7% in the non-SGLT-2iG. Safety was favorable, with no cases of ketoacidosis or severe infections and a trend toward fewer cardiovascular events in the SGLT-2iG (6.7% vs. 35.3%). Conclusions: In this two-center, real-world cohort, SGLT-2 inhibitor use in incident iHD patients was associated with a within-group increase in 24 h UO and non-significant trends toward preservation of KrU and CrCl over 12 months, together with an apparently favorable safety profile. Given the observational design and small sample, these hypothesis-generating findings should be interpreted with caution and warrant confirmation in dedicated randomized controlled trials.
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BibTeX
@article{flor2026effects,
title = {{Effects of Sodium-Glucose Cotransporter Type 2 Inhibitors on Residual Kidney Function in Patients Undergoing Incremental Hemodialysis: A Two-Center, Retrospective, Exploratory Cohort Study.}},
author = {José C De La Flor and Elena Jiménez Mayor and Avinash Chandu Nanwani and Celia Rodríguez Tudero and Francisco Valga and Esperanza Moral Berrio and Javier Deira and Jesús Hernández Vaquero and Gabriel de Arriba},
journal = {Medicina (Kaunas, Lithuania)},
year = {2026},
month = oct,
doi = {10.3390/medicina62101972},
url = {https://europepmc.org/article/MED/42942503},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of Sodium-Glucose Cotransporter Type 2 Inhibitors on Residual Kidney Function in Patients Undergoing Incremental Hemodialysis: A Two-Center, Retrospective, Exploratory Cohort Study.
AU - José C De La Flor
AU - Elena Jiménez Mayor
AU - Avinash Chandu Nanwani
AU - Celia Rodríguez Tudero
AU - Francisco Valga
AU - Esperanza Moral Berrio
AU - Javier Deira
AU - Jesús Hernández Vaquero
AU - Gabriel de Arriba
PY - 2026
DA - 2026/10/12
JO - Medicina (Kaunas, Lithuania)
DO - 10.3390/medicina62101972
UR - https://europepmc.org/article/MED/42942503
AB - Background and Objectives: The preservation of residual kidney function (RKF) is a major determinant of outcome in patients undergoing incremental hemodialysis (iHD). While sodium-glucose cotransporter-2 (SGLT-2) inhibitors have established nephroprotective benefits in non-dialysis chronic kidney disease (CKD), evidence regarding their role in preserving RKF after the initiation of hemodialysis remains limited. The primary objective of this study was to explore the impact of SGLT-2 inhibitors on the preservation of RKF in incident patients undergoing iHD over a 12-month follow-up. Materials and Methods: This study involved a two-center retrospective exploratory observational longitudinal study over 12 months of follow-up, including 32 incident iHD patients (one or two sessions per week, 1WHD or 2WHD). Participants were divided into a study group (SGLT-2iG, n = 15) receiving SGLT-2 inhibitors and a control group (non-SGLT-2iG, n = 17). RKF parameters, including 24 h (h) urine output (UO), urea clearance (KrU), and creatinine clearance (CrCl), were monitored quarterly. Results: Over 12 months, 24 h UO increased significantly within the SGLT-2iG (+573.3 mL; p < 0.001) and did not change significantly within controls (-202.9 mL, p = 0.34). KrU and CrCl showed only non-significant within-group trends (upward in the SGLT-2iG, downward in controls). Between-group differences were not formally tested and are described descriptively. A total of 80% of patients in SGLT-2iG maintained a 1WHD regimen at 12 months, compared with 46.7% in the non-SGLT-2iG. Safety was favorable, with no cases of ketoacidosis or severe infections and a trend toward fewer cardiovascular events in the SGLT-2iG (6.7% vs. 35.3%). Conclusions: In this two-center, real-world cohort, SGLT-2 inhibitor use in incident iHD patients was associated with a within-group increase in 24 h UO and non-significant trends toward preservation of KrU and CrCl over 12 months, together with an apparently favorable safety profile. Given the observational design and small sample, these hypothesis-generating findings should be interpreted with caution and warrant confirmation in dedicated randomized controlled trials.
SN - 1010-660X
SN - 1648-9144
ER -