Hyperkalemia and maintenance of renin–angiotensin system inhibitor therapy after initiating SGLT-2 or DPP-4 inhibitors

Oct 9, 2024Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

High potassium levels and continuing blood pressure medicine after starting SGLT-2 or DPP-4 diabetes drugs

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Abstract

In a study of 29,849 adults with type 2 diabetes, were associated with a lower rate of compared to DPP-4 inhibitors.

  • SGLT-2 inhibitors were linked to a 23% lower rate of hyperkalemia (hazard ratio 0.77) compared to DPP-4 inhibitors.
  • This reduction in hyperkalemia included a 24% lower rate of mild hyperkalemia and a 47% lower rate of moderate to severe hyperkalemia.
  • Seven percent of RAS inhibitor users discontinued therapy, but the initiation of SGLT-2 inhibitors did not influence the rate of RAS inhibitor discontinuation.
  • About one-third of participants in both groups discontinued treatment within one year.
  • Results were consistent across various patient subgroups, including sex and cardiovascular disease status.

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Key numbers

0.77
Lower Rate of
Adjusted hazard ratio for any events.
7%
Incidence of RASi Discontinuation
Percentage of participants who discontinued RASi therapy.
3.4%
1-Year Absolute Risk of
Absolute risk of in SGLT-2i users after one year.

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