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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.
SGLT2-inhibitors (SGLT2i) use has been reported to cause erythrocytosis, with post-hoc SGLT2i trial data showing Hb rise in patients on SGLT2i. We tested the hypothesis that haemoglobin (Hb) rise in chronic kidney disease (CKD) patients is associated with SGLT2i use and determined factors that predispose to the former.
This was a multicentre retrospective cohort study of CKD adults from three acute care hospitals and seven primary care institutions from 2022 to 2024 of patients on SGLT2i vs not on SGLT2i.Patients had eGFR < 60ml/min/m2 for 2 consecutive readings or diagnosis of “chronic kidney disease” and “chronic renal disease” with at least 2 Hb reading available for analysis.
We examined haemoglobin rise >1g/dL as the primary outcome, performed univariate analysis for baseline demographics and multivariate analysis to identify factors that contribute to Hb rise and identify potential confounders. Patients were stratified into 5 different age groups from <65 to >80 years.
Secondary outcome studied was new-onset polycythaemia by WHO criteria and Hb rise >0.5g/dL.We also performed a subgroup analysis for patients with BMI data available, stratified into 4 different groups from < 23kg/m2 to > 28kg/m2.
Of 6,671 patients, 397 were on SGLT2i; 6274 were not. SGLT2i users were younger (71 + 10 vs 75 + 11, p<0.001) with similar gender profiles (p=0.604). Median eGFR and BMI were higher in non-SGLT2i group with eGFR 44.8ml/min/m2 (33.0-53.0) and 25.9kg/m2 (23.0-29.1) vs 39.7ml/min/m2 (30.0-46.8) and 24.9kg/m2 (22.2-27.9) in SGLT2i group. Baseline Hb was higher in non-SGLT2i group with Hb 12.3 + 2.0 g/dL vs 12.1 + 1.9 g/dL in SGLT2i group (p=0.004). Erythropoietin stimulating agent (ESA) use was not significant between groups (p=0.202).
Mean Hb change was significantly higher at 0.2 ±1.0 g/dL in SGLT2i and -0.1 ± 2.0 g/dL in non-SGLT2i (p<0.001) over shorter mean days to follow up of 165 + 130 in SGLT2i vs 232 + 197 days in non-SGLT2i group (p<0.001). We detected significantly more Hb rise ³1g/dL in 19% of SGLT2i patients versus 10% non-SGLT2i users (p<0.001).
Multivariable analyses confirmed that SGLT2i was independently associated with Hb rise ³1g/dL (OR 1.88, 95% CI 1.42-2.50). We also found that additional factors of male gender (OR 1.79, 95% CI 1.50-2.13), younger age less than 75 years old (OR 1.44, 95% CI 1.13-1.81), especially those less than 65 years having greatest risk (OR 2.06, 95% CI 1.42-2.50) and higher Hb at baseline had lower risk of Hb rise >1g/dL (OR 0.67, 95% CI 0.64-0.71). Ethnicity, CKD staging, and ESA use did not have an impact on Hb rise.
Subgroup analysis of 3,749 patients with BMI data showed risk of Hb rise ³0.5g/dL with SGLT2i in patients with BMI ³25kg/m2 (OR 1.26, 95% CI 1.02-1.55) and highest risk with BMI > 28kg/m2 (OR 1.31, 95% CI 1.05-1.62). Lower CKD Stage G4-5 and those on ESA had a significantly lower risk of Hb rise >0.5g/dL. Few patients (3 SGLT2i and 59 non-SGLT2i) developed polycythemia (p=0.706).
Younger, male patients with CKD below the age of 75 years old are at higher risk for noticeable Hb rise with SGLT2i use. Overweight patients with BMI >25kg/m2 are at increased risk of Hb rise >0.5g/dL with SGLT2i use, with higher BMI conferring a greater risk. CKD Staging by GFR and ESA use had less impact on Hb rise. We recommend routine monitoring of Hb for patients who are newly initiated on SGLT2i.
[This abstract was also submitted for the 15th Singapore Society of Nephrology Annual Scientific Meeting 2025.]
