Frontiers in Pharmacology · Oct 31, 2026
Sodium-glucose cotransporter-2 inhibitors and risk of incident kidney disease in patients with gout
By Fu-Shun Yen, Jing-Yang Huang, Yao-Min Hung et al.
Objective: This study aimed to compare the risk of kidney outcomes in patients with gout and type 2 diabetes (T2D) who used sodium-glucose cotransporter-2 inhibitors (SGLT2i) and those who did not. Methods: Using the TriNetX US Collaborative Network, we conducted a retrospective cohort study comparing patients with gout and type 2 diabetes who initiated SGLT2i or dipeptidyl peptidase-4 inhibitors (DPP-4i). After 1:1 propensity score matching, 2,676 pairs were included in the primary active-comparator analysis. Kidney outcomes, hospitalization, and all-cause mortality were evaluated using Cox proportional hazards models. A comparison between SGLT2i users and nonusers was retained as a secondary analysis. Results: In the primary analysis, SGLT2i initiation was associated with lower risks of composite kidney outcomes (HR, 0.848; 95% CI, 0.775–0.929), incident CKD (HR, 0.851; 95% CI, 0.777– 0.932), and all-cause mortality (HR, 0.702; 95% CI, 0.571–0.864) compared with DPP-4i initiation. No statistically significant differences were observed in dialysis or kidney transplantation (HR, 0.685; 95% CI, 0.388–1.210) or all-cause hospitalization (HR, 0.941; 95% CI, 0.857–1.032). Findings from the secondary SGLT2i versus non-SGLT2i analysis were generally consistent. Conclusion: Our study found that SGLT2i use in patients with gout and T2D was associated with a lower risk of developing CKD, and all-cause mortality, compared to those not using SGLT2i.