Diabetes research and clinical practice · 2026
B-type natriuretic peptide level reduction and its predictors following sodium-glucose cotransporter 2 inhibitor treatment in patients with diabetic kidney disease: a Japan Chronic Kidney Disease Database Extension analysis.
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Nagahiro Takanori, Konishi Masaaki, Kanaoka Tomohiko, Wakui Hiromichi, Yano Yuichiro, Nagasu Hajime, Kishi Seiji, Nangaku Masaomi, Hirakawa Yosuke, Nakagawa Naoki, Wada Jun, Tsuruya Kazuhiko, Nakano Toshiaki, Maruyama Shoichi, Wada Takashi, Yamagata Kunihiro, Narita Ichiei, Yanagita Motoko, Terada Yoshio, Araki Shin-Ichi, Emoto Masanori, Okada Hirokazu, Isaka Yoshitaka, Suzuki Yusuke, Yokoo Takashi, Kataoka Hiromi, Kanda Eiichiro, Kashihara Naoki, Tamura Kouichi, J-CKD-DB Collaborators
Аннотация
AIMS/INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) prevent cardiovascular events in patients with diabetic kidney disease (DKD). However, limited data exist regarding the change in B-type natriuretic peptide (BNP) after treatment. This study investigated whether SGLT2i are associated with a greater BNP reduction than other antidiabetic drugs and identified the predictors of BNP reduction following SGLT2i.
MATERIALS AND METHODS: Using the Japanese nationwide database, we compared BNP levels before and 30-365 days after initiation of antidiabetic medication in 1818 patients with DKD (71 ± 12 years, 68% men, BNP 71 [27-190] pg/mL, estimated glomerular filtration rate (eGFR) 51 ± 22 mL/min/1.73 m2).
RESULTS: BNP reduction, defined as a reduction of >10%, occurred in 474 (50.5%) of 939 patients treated with SGLT2i and 339 (38.6%) of 879 treated with other antidiabetic drugs. SGLT2i was associated with BNP level reduction in a multivariable logistic regression analysis (odds ratio, 1.497 [1.206-1.859]; p < 0.001). This association was consistent across eGFR, proteinuria, and multiple BNP endpoints. Concomitant use of loop diuretics was associated with a lower rate of BNP reduction after SGLT2i.
CONCLUSIONS: Compared with other antidiabetic drugs, SGLT2i was substantially associated with BNP reduction in a broad spectrum of DKD.
MATERIALS AND METHODS: Using the Japanese nationwide database, we compared BNP levels before and 30-365 days after initiation of antidiabetic medication in 1818 patients with DKD (71 ± 12 years, 68% men, BNP 71 [27-190] pg/mL, estimated glomerular filtration rate (eGFR) 51 ± 22 mL/min/1.73 m2).
RESULTS: BNP reduction, defined as a reduction of >10%, occurred in 474 (50.5%) of 939 patients treated with SGLT2i and 339 (38.6%) of 879 treated with other antidiabetic drugs. SGLT2i was associated with BNP level reduction in a multivariable logistic regression analysis (odds ratio, 1.497 [1.206-1.859]; p < 0.001). This association was consistent across eGFR, proteinuria, and multiple BNP endpoints. Concomitant use of loop diuretics was associated with a lower rate of BNP reduction after SGLT2i.
CONCLUSIONS: Compared with other antidiabetic drugs, SGLT2i was substantially associated with BNP reduction in a broad spectrum of DKD.