The International Tinnitus Journal

The Effect of Sodium???Glucose Co-Transporter-2 Inhibitors in Contrast-Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis

Author(s): Mahmood Reza Hashemi Rafsanjani, Kiana Rezvanfar, Dena Saghafi, Sara sabbaghi, Bahar Parastooei, Mohammad Darvishi*

Background and Aims: Contrast-Induced Acute Kidney Injury (CI-AKI) is the third leading cause of hospital-acquired renal damage, associated with increased mortality and morbidity. Despite CI-AKI incidence decline, it remains a concern, especially during procedures like percutaneous coronary intervention, impacting the vulnerable elderly with compromised renal function. This study aimed at assessing the effect of Sodium–Glucose Transporter-2 Inhibitors in contrasting induced nephropathy. Methods and Materials: Authors performed a systematic search of literature in Web of Science, Scopus, and PubMed with relevant keywords. Our eligibility criteria were defined based on the PICO framework. The pooled odds ratios were calculated using random effects model and Mantel-Haenszel method along with the 95% confidence intervals. For assessing the heterogeneity of the included studies, the I2 (I square) test was used. R and RStudio were used for the statistical analysis. Results: Overall, from 20 records, 5 studies were added for final analysis. Based on the pooled OR of the included studies, there was no significant association between exposure to SGLT2-type drugs and CI-AKI compared to the control groups [OR=0.86, 95%CI: 0.29 – 2.51, p-value = 0.78]. Based on the pooled mean eGFR of the included studies, there was a significant association between exposure to SGLT2-type drugs and lower levels of eGFR compared to the control groups [MD=-4.00, 95%CI: -7.75 – -0.24, p-value = 0.04]. Conclusion: In conclusion, we assessed the impact of Sodium-Glucose Co-Transporter 2 Inhibitors (SGLT2i) on Contrast-Induced Acute Kidney Injury (CI-AKI). No significant association between SGLT2i use and CI-AKI risk was found, but a notable link emerged between SGLT2-type drug exposure and lower Estimated Glomerular Filtration Rate (eGFR). Uncertainty persists on whether SGLT2i prevent or contribute to CI-AKI, with a suggestion to temporarily halt SGLT2i before contrast studies, particularly in certain patients.

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