Frequency of contrast nephropathy in patients with a history of coronary angiography and SGLT-2 inhibitor use

Contrast-induced nephropathy has been defined as acute kidney injury due to intravenous contrast agents used in diagnostic or therapeutic procedures. In this study, we aimed to investigate the effect of SGLT-2i on renal function by comparing creatinine levels before and 48 hours after the intervention in patients who had previously undergone angiography in our clinic. Compared with the baseline creatinine level, the 48th hour creatinine levels were statistically significantly increased in the entire patient population (change rate 6.22%), in those taking SGLT-2 (change rate 6.92%) and in those with HbA1c levels above 6.4% (change rate 6.56%) (p=0.006; p=0.032 and p=0.008, respectively). When re-divided into groups according to HbA1c levels, patients with low HbA1c levels (≤6.4%) did not have a significant increase in 48.hour creatinine levels compared with baseline values whether they received SGLT-2i or not. In patients with high HbA1c levels (≥6.4%), there was a significant increase in creatinine in the group receiving SGLT-2i. In our study, the use of SGLT-2i did not cause a significant increase in CN, but may cause significant increases in creatinine progression in patients with uncontrolled diabetes. Identification of high-risk patients, adequate hydration, reduction in the amount of contrast used, and close monitoring of renal function before and after the procedure may be considered safe. Further large-scale studies are needed to determine the benefits or harms of these drugs in CN. Keywords: Contrast Induced Nephropathy, Coronary angiography, Diabetes mellitus, SGLT-2 inhibitors