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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Although sodium–glucose cotransporter 2 inhibitors (SGLT2i) are now widely used in chronic kidney disease (CKD), the efficacy and safety of initiating SGLT2i in advanced CKD remain uncertain. We investigated the potential benefits of SGLT2i initiation in patients with CKD stage G4–5.
We conducted a single-center retrospective cohort study using electronic medical records from Shinshu University Hospital. Patients who newly initiated SGLT2i between 2017 and 2022 with baseline eGFR <30 mL/min/1.73 m² were defined as the SGLT2i group. Patients without SGLT2i prescriptions during the same period and with eGFR <30 mL/min/1.73 m² were assigned to the untreated group, with a randomly allocated inclusion date. Patients aged <18 years or with prior renal death (hemodialysis, peritoneal dialysis, or kidney transplantation) were excluded from both groups. Propensity score matching (PSM, 1:1) was performed based on age, sex, comorbidities, baseline eGFR, and department to construct a matched control group. The primary outcome was renal death during up to 24 months of follow-up; secondary outcomes included all-cause mortality, eGFR slope, and events potentially related to SGLT2i treatment such as urinary tract infection (UTI).
A total of 79 patients were included in the SGLT2i group and 892 in the untreated group. After PSM, 78 matched pairs were analyzed. Baseline eGFR was similar between groups (mean ± standard deviation [SD], 21.37±5.13 and 21.17±6.75 mL/min/1.73 m², SMD = 0.034). The mean observation period was 659±135 days in the SGLT2i group and 474±258 days in the untreated group (p < 0.001). The mean duration of SGLT2i treatment was 561±254 days; 32 patients (41.0%) discontinued therapy. Reasons for discontinuation included initiation of renal replacement therapy (12 patients, 37.5%), eGFR decline (5, 15.6%), urinary tract infection (4, 12.5%), and gastrointestinal symptoms (3, 9.4%). Renal death occurred in 17 (21.8%) and 21 (26.9%) patients in the SGLT2i and untreated groups, respectively (12.1 and 20.8 per 100 person-years; log-rank p = 0.009). All-cause mortality was lower in the SGLT2i group (7 [9.0%] and 14 [17.9%]; 4.97 and 13.84 per 100 person-years; log-rank p = 0.008). The eGFR slope during the 24-month observation period was similar (mean ± standard error [SE], －0.28±0.36 and －0.66±0.30 mL/min/1.73 m² per year; p = 0.294), whereas the chronic phase slope (2-24 months) was significantly smaller decline in the SGLT2i group (−0.18±0.43 and −1.78±0.37 mL/min/1.73 m² per year; p < 0.001). The incidence of predefined events such as UTI was similar between groups.
In patients with eGFR < 30 mL/min/1.73 m², initiation of SGLT2i therapy was significantly associated with a lower risk of renal death and all-cause mortality and slowed eGFR decline. These findings suggest that SGLT2i may exert renoprotective effects even in advanced CKD.
