Effect of Baseline Values of Renal Prognosis-related Factors on Their Changes after Initiating Tofogliflozin Treatment: A Retrospective Study in Japanese Patients with Type 2 Diabetes and Renal Impairment

JMA J. 2024 Oct 15;7(4):571-579. doi: 10.31662/jmaj.2024-0128. Epub 2024 Sep 6.

Abstract

Introduction: This study investigated the relationships between changes in renal prognosis-related factors after initiating tofogliflozin and the corresponding baseline values in clinical practice in Japanese patients with type 2 diabetes.

Methods: We investigated the relationships between changes in hematocrit, hemoglobin, systolic blood pressure (sBP), urinary protein excretion (uPE), serum uric acid (sUA), and estimated glomerular filtration rate (eGFR) 12 months after initiating tofogliflozin (20 mg) and their corresponding baseline values in 130 patients with type 2 diabetes. The subjects were divided into two groups: normal (≥60 mL/min/1.73 m2, n = 87) and low (<60 mL/min/1.73 m2, n = 43) eGFR.

Results: Although the change in eGFR was negatively correlated with the baseline value in the normal-eGFR group, no significant correlation was found between the change in eGFR and baseline value in the low-eGFR group. Although changes in hematocrit (r = -0.39, P = 0.01) and hemoglobin (r = -0.36, P = 0.02) levels were significantly negatively correlated with corresponding baseline values in the low-eGFR group, no significant correlations were observed in the normal-eGFR group. Changes in sBP, uPE, and sUA were significantly negatively correlated with the corresponding baseline values in both the normal- and low-eGFR groups. None of the correlation coefficients between the normal- and low-eGFR groups showed a significant difference.

Conclusions: Favorable changes in renal prognosis-related factors after tofogliflozin therapy may contribute to renoprotection in patients with type 2 diabetes and poor corresponding baseline values, despite the presence of renal impairment.

Keywords: Sodium-glucose cotransporter 2 inhibitors; diabetic kidney disease; hematocrit; hemoglobin; tofogliflozin; uric acid.