Nephroprotective effect of sodium-glucose cotransporter-2 inhibitors in patients with atrial fibrillation and chronic kidney disease
https://doi.org/10.15829/1728-8800-2026-4629
EDN: CCEEIT
Abstract
Aim. To evaluate the changes of renal function during treatment with sodium-glucose cotransporter-2 (SGLT-2) inhibitors in patients with atrial fibrillation (AF) and chronic kidney disease (CKD).
Material and methods. A total of 100 patients with AF and stage 3-4 CKD were included. Serum creatinine levels, creatinine clearance (CrCl) according to the Cockcroft-Gault equation, and glomerular filtration rate (GFR) using the CKD-EPI equation were assessed. A decrease in GFR ≥20%, a doubling of creatinine levels, and the development of acute kidney injury (AKI) were analyzed.
Results. After 18 months, the GFR in the study group averaged 10,1 (95% confidence interval: 3,6; 16,7) ml/min/1,73 m2 higher than in the control group. In patients with stage C3B CKD, the GFR level increased by 4,3±10,5 ml/min/1,73 m2 from baseline. Patients taking SGLT-2 inhibitors had an increased risk of progression from stage C3B CKD to stage C3A: odds ratio (OR) =0,53; 95% confidence interval: 0,42; 0,67. Differences in kidney function were observed only with renin-angiotensin system inhibitors. No doubling of creatinine levels or development of acute kidney injury was observed. There were no differences between groups in the incidence of a decrease in GFR ≥20%.
Conclusion. The renoprotective effect of SGLT-2 inhibitors is maintained in patients with combined AF and CKD, especially in patients with CKD stage C3B.
About the Authors
A. I. Listratov
I.M. Sechenov First Moscow State Medical University (Sechenov University).
Russian Federation
Russian Federation
Alexander I. Listratov — postgraduate student of the Department of Faculty Therapy № 1
Trubetskaya str., 8, bld. 2, Moscow, 119048
D. A. Napalkov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Dmitry A. Napalkov — professor of the Department of Faculty Therapy № 1
Trubetskaya str., 8, bld. 2, Moscow, 119048
A. A. Sokolova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Anastasiya A. Sokolova — professor of the Department of Faculty Therapy № 1
Trubetskaya str., 8, bld. 2, Moscow, 119048
V. V. Fomin
I.M. Sechenov First Moscow State Medical University (Sechenov University);
Russian Medical Academy of Continuous Professional Education.
Russian Federation
Russian Federation
Victor V. Fomin — professor of the Department of Faculty Therapy № 1; Acting Rector
Trubetskaya str., 8, bld. 2, Moscow, 119048,
Barrikadnaya str., 2/1, bld. 1, Moscow, 125993
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What is already known about the subject?
- The combination of atrial fibrillation (AF) and chronic kidney disease (CKD) leads to a further decline in kidney function.
- Sodium-glucose cotransporter 2 inhibitors are a new class of drugs with proven nephroprotective action and are recommended for use in patients with CKD.
What might this study add?
- In patients with a combination of AF and CKD, sodium-glucose cotransporter 2 inhibitors have a more pronounced nephroprotective effect in patients with stage C3B CKD.
- To achieve a positive effect on kidney function in patients with AF, these drugs must be combined with renin-angiotensin system inhibitors.
Review
For citations:
Listratov A.I., Napalkov D.A., Sokolova A.A., Fomin V.V. Nephroprotective effect of sodium-glucose cotransporter-2 inhibitors in patients with atrial fibrillation and chronic kidney disease. Cardiovascular Therapy and Prevention. 2026;25(5):4629. (In Russ.) https://doi.org/10.15829/1728-8800-2026-4629. EDN: CCEEIT
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