{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:26:38Z","timestamp":1793795198714,"version":"4.6.1"},"reference-count":15,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T00:00:00Z","timestamp":1508716800000},"content-version":"vor","delay-in-days":63,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23-DK-107908"],"award-info":[{"award-number":["K23-DK-107908"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23-DK-1065501"],"award-info":[{"award-number":["K23-DK-1065501"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01-DK-096549"],"award-info":[{"award-number":["R01-DK-096549"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["U01-DK-106962"],"award-info":[{"award-number":["U01-DK-106962"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Sodium-glucose cotransporter-2 (SGLT2) inhibitors are new medications that improve cardiovascular and renal outcomes in patients with type 2 diabetes (T2D). However, the Food and Drug Administration has issued alerts regarding increased acute kidney injury (AKI) risk with canagliflozin and dapagliflozin. We aimed to assess the real-world risk of AKI in new SGLT2 inhibitor users in two large health care utilization cohorts of patients with T2D.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We used longitudinal data from the Mount Sinai chronic kidney disease registry and the Geisinger Health System cohort. We selected SGLT inhibitor users and nonusers (patients with T2D without SGLT2 inhibitor prescription). We determined AKI by the KDIGO (Kidney Disease: Improving Global Outcomes) definition (AKIKDIGO). We performed 1:1 nearest-neighbor propensity matching and calculated unadjusted hazard ratios (HRs) and adjusted HRs (aHRs; accounting for covariates poorly balanced) for AKI in primary and sensitivity analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We identified 377 SGLT2 inhibitor users and 377 nonusers in the Mount Sinai cohort, of whom 3.8 and 9.7%, respectively, had an AKIKDIGO event over a median follow-up time of 14 months. The unadjusted hazards of AKIKDIGO were 60% lower in users (HR 0.4 [95% CI 0.2\u20130.7]; P = 0.01), which was unchanged (aHR 0.4 [95% CI 0.2\u20130.7]; P = 0.004) postadjustment. Similarly, we identified 1,207 SGLT2 inhibitor users and 1,207 nonusers in the Geisinger cohort, of whom 2.2 and 4.6% had an AKIKDIGO event. AKIKDIGO unadjusted hazards were lower in users (HR 0.5 [95% CI 0.3\u20130.8]; P &amp;lt; 0.01) with modest attenuation postadjustment for covariates (aHR 0.6 [95% CI 0.4\u20131.1]; P = 0.09). These estimates did not qualitatively change across several sensitivity analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our findings do not suggest an increased risk of AKI associated with SGLT2 inhibitor use in patients with T2D in two large health systems.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc17-1011","type":"journal-article","created":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T00:20:13Z","timestamp":1503361213000},"page":"1479-1485","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":167,"title":["Acute Kidney Injury in Patients on SGLT2 Inhibitors: A Propensity-Matched Analysis"],"prefix":"10.2337","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6319-4314","authenticated-orcid":false,"given":"Girish N.","family":"Nadkarni","sequence":"first","affiliation":[{"name":"Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Ferrandino","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Geisinger Medical Center, Danville, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Surapaneni","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinsuk","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priti","family":"Poojary","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Ferket","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4430-6023","authenticated-orcid":false,"given":"Morgan E.","family":"Grams","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Coca","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2017,8,21]]},"reference":[{"key":"2022031301533341100_B1","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1001\/jama.2014.11494","article-title":"Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980\u20132012","volume":"312","author":"Geiss","year":"2014","journal-title":"JAMA"},{"key":"2022031301533341100_B2","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.2337\/dci15-0012","article-title":"Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: a scientific statement from the American Heart Association and the American Diabetes Association","volume":"38","author":"Fox","year":"2015","journal-title":"Diabetes Care"},{"key":"2022031301533341100_B3","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/2040622314546125","article-title":"Cardiovascular impact of drugs used in the treatment of diabetes","volume":"5","author":"Triggle","year":"2014","journal-title":"Ther Adv Chronic Dis"},{"key":"2022031301533341100_B4","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N Engl J Med"},{"key":"2022031301533341100_B5","article-title":"Canagliflozin and cardiovascular and renal events in type 2 diabetes","author":"Neal","journal-title":"N Engl J Med"},{"key":"2022031301533341100_B6","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1056\/NEJMoa1515920","article-title":"Empagliflozin and progression of kidney disease in type 2 diabetes","volume":"375","author":"Wanner","year":"2016","journal-title":"N Engl J Med"},{"key":"2022031301533341100_B7","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) [article online], 2016. Available from https:\/\/www.fda.gov\/Drugs\/DrugSafety\/ucm505860.htm. Accessed 21 April 2017"},{"key":"2022031301533341100_B8","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/j.1464-5491.2011.03498.x","article-title":"Risk of acute renal failure in patients with type 2 diabetes mellitus","volume":"29","author":"Girman","year":"2012","journal-title":"Diabet Med"},{"key":"2022031301533341100_B9","first-page":"907","article-title":"Development and validation of an electronic phenotyping algorithm for chronic kidney disease","volume-title":"AMIA Annu Symp Proc","author":"Nadkarni","year":"2014"},{"key":"2022031301533341100_B10","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/cc11454","article-title":"Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1)","volume":"17","author":"Kellum","year":"2013","journal-title":"Crit Care"},{"key":"2022031301533341100_B11","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s13300-014-0089-4","article-title":"Sodium glucose co-transporter-2 (SGLT2) inhibitors: a review of their basic and clinical pharmacology","volume":"5","author":"Kalra","year":"2014","journal-title":"Diabetes Ther"},{"key":"2022031301533341100_B12","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1038\/nrneph.2016.159","article-title":"Acute kidney injury from SGLT2 inhibitors: potential mechanisms","volume":"12","author":"Hahn","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"2022031301533341100_B13","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.2337\/dc16-2200","article-title":"Potential hypoxic renal injury in patients with diabetes on SGLT2 inhibitors: caution regarding concomitant use of NSAIDs and iodinated contrast media","volume":"40","author":"Heyman","year":"2017","journal-title":"Diabetes Care"},{"key":"2022031301533341100_B14","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/03007995.2016.1271780","article-title":"Longer-term safety and tolerability of canagliflozin in patients with type 2 diabetes: a pooled analysis","volume":"33","author":"Qiu","year":"2017","journal-title":"Curr Med Res Opin"},{"key":"2022031301533341100_B15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1056\/NEJMra1214243","article-title":"Acute kidney injury and chronic kidney disease as interconnected syndromes","volume":"371","author":"Chawla","year":"2014","journal-title":"N Engl J Med"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/care.diabetesjournals.org\/syndication\/doi\/10.2337\/dc17-1011","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/40\/11\/1479\/552032\/dc171011.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/40\/11\/1479\/552032\/dc171011.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T05:57:46Z","timestamp":1647151066000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/40\/11\/1479\/37010\/Acute-Kidney-Injury-in-Patients-on-SGLT2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,21]]},"references-count":15,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2017,8,21]]},"published-print":{"date-parts":[[2017,11,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc17-1011","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,21]]}}}