A large real-world study in Ontario, Canada, found that starting sodium-glucose cotransporter 2 inhibitors (SGLT2i) in older adults already taking renin-angiotensin-aldosterone system inhibitors was associated with a reduced risk of hyperkalemia, leading to fewer cases of hyperkalemia and less treatment interruption. The study included over 39,000 adults aged 66 and older with diabetes, heart failure, or chronic kidney disease, and the results indicated a lower incidence of hyperkalemia and decreased hospital encounters for hyperkalemia among SGLT2i users. SGLT2i users were also more likely to continue their renin-angiotensin-aldosterone system therapy. The protective effects of SGLT2i on kidney and cardiovascular health were highlighted, suggesting a potential positive impact on the implementation of optimal guideline-directed medical therapy in patients with diabetes, CKD, and heart failure.

Source: JAMA Internal Medicine