Investigation of cardiorenal outcomes and incidence of genitourinary tract infection after combined SGLT2 inhibitor and ACEI/ARB use in patients with chronic kidney disease stages 3-5: A real-world retrospective cohort study in Taiwan.

In our cohort, SGLT2 inhibitor users had a slightly lower incidence of CHF, arrhythmias, and AKD during follow-up, but the adjusted hazard ratio (aHR) did not reach statistical significance.

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The major findings showed that (1) SGLT2 inhibitor use was associated with a significantly increased incidence of GUTIs (aHR = 1.78, 95% CI = 1.12~2.84), which usually occurred within months after initiation; (2) increased GUTI rates among SGLT2 inhibitor users persisted regardless of their GUTI history, with an increasing trend for patients with prior GUTIs, although not statistically significant for a prior GUTI history; (3) SGLT2 inhibitor users had a significant reduction in the risk of ESRD/dialysis (aHR = 0.35, 95% CI = 0.19~0.67), but SGLT2 inhibitor use was not associated with the risk of AKI or subsequent AKD; and (4) SGLT2 inhibitor users with a history of CVDs had higher CVD rates, whereas patients without a CVD history had lower CHF, arrhythmia, and AMI rates, although these rates did not significantly differ between patients with and without a CVD history.

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