{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:59:39Z","timestamp":1777503579771,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Recent clinical trials suggest benefit of anti-hyperglycemic drugs on kidney outcomes. However, there is a paucity of information available on the real-world impact.We aimed to study the real-world impact of anti-hyperglycemic drugs (metformin, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1receptor (GLP-1R) agonists) using a cohort of patients with incident diabetes derived from the Alberta Tomorrow Project (ATP) database. A retrospective cohort was created from the ATP database using administrative data from October 1, 2000, to March 31, 2021. We examined the effect of anti-hyperglycemic medications including metformin (as a control), SGLT-2 inhibitors, DPP-4 inhibitors, and GLP-1R agonists on a composite kidney outcome including chronic kidney disease, kidney failure, dialysis, kidney transplant, and kidney-related death using a Cox-regression analysis.<\/jats:p>\n                  <jats:p>\n                    The study included 3001 patients with an incident diagnosis of diabetes. The average follow-up was 6.7 \u00b1 4.6 years after diagnosis, and 628 (20.9%) patients reached the composite outcome with a mean of 5.6 \u00b1 4.2 years to the first event. A total of 1749 (58.8%) patients were on metformin, 360 (12.0%) on SGLT-2 inhibitors, 313 (10.4%) on DPP-4 inhibitors, and 188 (6.3%) on GLP-1R agonists. Only the patients prescribed SGLT-2 inhibitors had a significant reduction in the composite outcome (hazard ratio (HR) 0.23, 95% CI 0.09-0.62,\n                    <jats:italic>P<\/jats:italic>\n                    -value = .003), and a dose-related effect was observed. Our study has shown that SGLT-2 inhibitors result in significant reduction of composite kidney outcomes, including chronic kidney disease, suggesting a renally protective effect over long term.\n                  <\/jats:p>","DOI":"10.1177\/20543581251365364","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T08:42:47Z","timestamp":1755852167000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The \u201cReal-World\u201d Effect of Anti-hyperglycemic Drugs on the Development of Chronic Kidney Disease in a Retrospective Cohort of Patients With Incident Diabetes: A Research Letter"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4280-5408","authenticated-orcid":false,"given":"Anita","family":"Dahiya","sequence":"first","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ye","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer E.","family":"Vena","sequence":"additional","affiliation":[{"name":"Alberta\u2019s Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Shen Tu","sequence":"additional","affiliation":[{"name":"Alberta\u2019s Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean T.","family":"Eurich","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/20543581221150556"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2019.01.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00271-7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30256-6"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15364"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.100847"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267025"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15361"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5566"}],"container-title":["Canadian Journal of Kidney Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20543581251365364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20543581251365364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20543581251365364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:22:02Z","timestamp":1777389722000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20543581251365364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":10,"alternative-id":["10.1177\/20543581251365364"],"URL":"https:\/\/doi.org\/10.1177\/20543581251365364","relation":{},"ISSN":["2054-3581","2054-3581"],"issn-type":[{"value":"2054-3581","type":"print"},{"value":"2054-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"20543581251365364"}}