{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T09:59:05Z","timestamp":1781603945407,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>Studies have demonstrated sodium\u2010glucose cotransporter\u20102 (SGLT2) inhibitors are kidney protective; however, their ability to cause hemodynamic changes may predispose patients to acute kidney injury (AKI). An FDA warning recommends evaluating for factors that predispose patients to AKI before initiating a SGLT2 inhibitor. The primary objective of this study is to identify risk factors that may predispose persons with diabetes to AKI when initiating SGLT2 inhibitor therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Multicenter retrospective cohort chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>Study patients were identified through an electronic medical record generated report if they had type 2 diabetes and were prescribed a SGLT2 inhibitor from January 2013 to September 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients were included if they were receiving care at Advocate Medical Group and were confirmed to have taken one of the four SGLT2 inhibitors available at the time of study approval, canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin, for at least 7\u2009days. Patients were excluded if they did not have a basic metabolic panel or comprehensive metabolic panel recorded 1\u2009year prior to or 6\u2009months after SGLT2 inhibitor therapy initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data extraction from the electronic medical record identified 6425 patients receiving a SGLT2 inhibitor, of which 1962 met inclusion criteria and were included for analysis. Thirty\u2010five (1.8%) patients experienced an AKI after SGLT2 inhibitor therapy initiation. There was no statistically significant difference between groups based on background medication use (<jats:italic>p<\/jats:italic>\u2009=\u20090.325). At baseline, patients experiencing an AKI after SGLT2 inhibitor initiation were more likely to be older in age (<jats:italic>p<\/jats:italic>\u2009=\u20090.010), have a higher serum potassium (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), blood glucose (<jats:italic>p<\/jats:italic>\u2009=\u20090.018), SCr (<jats:italic>p<\/jats:italic>\u2009=\u20090.009) and UACR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and a lower eGFR (<jats:italic>p<\/jats:italic>\u2009=\u20090.028) compared to those who did not experience AKI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The transient eGFR decline with SGLT2 inhibitor initiation should be expected and is generally not an indication to discontinue therapy. Future initiatives should be directed at increasing knowledge of monitoring recommendations for these agents.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2902","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T04:06:45Z","timestamp":1703218005000},"page":"249-257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Identification of risk factors associated with acute kidney injury in patients taking <scp>sodium\u2010glucose<\/scp> cotransporter\u20102 inhibitors"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-1590","authenticated-orcid":false,"given":"Christie","family":"Schumacher","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice Midwestern University College of Pharmacy, Downers Grove Campus  Downers Grove Illinois USA"},{"name":"Pharmacy, Chronic Disease Management Advocate Health  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Chorpash","sequence":"additional","affiliation":[{"name":"Pharmacy, Chronic Disease Management Advocate Health  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9797-6557","authenticated-orcid":false,"given":"Charlotte","family":"Bolch","sequence":"additional","affiliation":[{"name":"Office of Research and Sponsored Programs Midwestern University  Glendale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellye","family":"Eagan","sequence":"additional","affiliation":[{"name":"Pharmacy, Chronic Disease Management Advocate Health  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Nimer","sequence":"additional","affiliation":[{"name":"Pharmacy, Chronic Disease Management Advocate Health  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6138-1113","authenticated-orcid":false,"given":"Elizabeth","family":"Van\u00a0Dril","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice University of Illinois Chicago College of Pharmacy  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"2022 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"United States Renal Data System","year":"2022"},{"key":"e_1_2_10_3_1","unstructured":"Centers for Disease Control and Prevention.Chronic Kidney Disease in the United States 2023.2023. Atlanta GA: US Department of Health and Human Services. Accessed July 3 2023.https:\/\/www.cdc.gov\/kidneydisease\/pdf\/CKD\u2010Factsheet\u2010H.pdf"},{"key":"e_1_2_10_4_1","unstructured":"Centers for Disease Control and Prevention.Coexisting Conditions and Complications. Accessed September 1 2023.https:\/\/www.cdc.gov\/diabetes\/data\/statistics\u2010report\/coexisting\u2010conditions\u2010complications.html"},{"issue":"4","key":"e_1_2_10_5_1","first-page":"S1","article-title":"KDIGO 2022 clinical practice guideline for diabetes Management in Chronic Kidney Disease","volume":"102","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group","year":"2022","journal-title":"Kidney Int"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.02.338"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06080616"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.021887"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.12.021"},{"key":"e_1_2_10_10_1","unstructured":"U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA Strengthens Kidney Warnings for Diabetes Medicines Canagliflozin (Invokana Invokamet) and Dapagliflozin (Farxiga Xigduo XR). Accessed July 3 2023.https:\/\/www.fda.gov\/drugs\/drug\u2010safety\u2010and\u2010availability\/fda\u2010drug\u2010safety\u2010communication\u2010fda\u2010strengthens\u2010kidney\u2010warnings\u2010diabetes\u2010medicines\u2010canagliflozin2016."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12917"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204233"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2024816"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1811744"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.09.015"},{"issue":"1","key":"e_1_2_10_16_1","first-page":"S1","article-title":"Standards of medical care in diabetes \u2013 2023","volume":"46","author":"American Diabetes Association","year":"2023","journal-title":"Diabetes Care"},{"issue":"18","key":"e_1_2_10_17_1","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA guideline for the Management of Heart Failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"145","author":"Heidenreich PA","year":"2022","journal-title":"Circulation"},{"key":"e_1_2_10_18_1","first-page":"1","article-title":"KDIGO clinical practice guideline for acute kidney injury","volume":"17","author":"KDIGO AKI Work Group","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021020167"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dcS15-3006"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnz010"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02074-8"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.10.042"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T10:23:45Z","timestamp":1761042225000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,12]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/phar.2902"],"URL":"https:\/\/doi.org\/10.1002\/phar.2902","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,12]]},"assertion":[{"value":"2023-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}