Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials
Hyperkalemia increases risk of cardiac arrhythmias and death and limits the use of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, which improve clinical outcomes in people with chronic kidney disease or systolic heart failure. Sodium-glucose cotransporter...
Gespeichert in:
| Veröffentlicht in: | Circulation (New York, N.Y.) Jg. 145; H. 19; S. 1460 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
10.05.2022
|
| Schlagworte: | |
| ISSN: | 1524-4539, 1524-4539 |
| Online-Zugang: | Weitere Angaben |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Abstract | Hyperkalemia increases risk of cardiac arrhythmias and death and limits the use of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, which improve clinical outcomes in people with chronic kidney disease or systolic heart failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of cardiorenal events in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease. However, their effect on hyperkalemia has not been systematically evaluated.
A meta-analysis was conducted using individual participant data from randomized, double-blind, placebo-controlled clinical outcome trials with SGLT2 inhibitors in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease in whom serum potassium levels were routinely measured. The primary outcome was time to serious hyperkalemia, defined as central laboratory-determined serum potassium ≥6.0 mmol/L, with other outcomes including investigator-reported hyperkalemia events and hypokalemia (serum potassium ≤3.5 mmol/L). Cox regression analyses were performed to estimate treatment effects from each trial with hazards ratios and corresponding 95% CIs pooled with random-effects models to obtain summary treatment effects, overall and across key subgroups.
Results from 6 trials were included comprising 49 875 participants assessing 4 SGLT2 inhibitors. Of these, 1754 participants developed serious hyperkalemia, and an additional 1119 investigator-reported hyperkalemia events were recorded. SGLT2 inhibitors reduced the risk of serious hyperkalemia (hazard ratio, 0.84 [95% CI, 0.76-0.93]), an effect consistent across studies (
=0.71). The incidence of investigator-reported hyperkalemia was also lower with SGLT2 inhibitors (hazard ratio, 0.80 [95% CI, 0.68-0.93];
=0.21). Reductions in serious hyperkalemia were observed across a range of subgroups, including baseline kidney function, history of heart failure, and use of renin-angiotensin-aldosterone system inhibitor, diuretic, and mineralocorticoid receptor antagonist. SGLT2 inhibitors did not increase the risk of hypokalemia (hazard ratio, 1.04 [95% CI, 0.94-1.15];
=0.42).
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia. |
|---|---|
| AbstractList | Hyperkalemia increases risk of cardiac arrhythmias and death and limits the use of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, which improve clinical outcomes in people with chronic kidney disease or systolic heart failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of cardiorenal events in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease. However, their effect on hyperkalemia has not been systematically evaluated.
A meta-analysis was conducted using individual participant data from randomized, double-blind, placebo-controlled clinical outcome trials with SGLT2 inhibitors in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease in whom serum potassium levels were routinely measured. The primary outcome was time to serious hyperkalemia, defined as central laboratory-determined serum potassium ≥6.0 mmol/L, with other outcomes including investigator-reported hyperkalemia events and hypokalemia (serum potassium ≤3.5 mmol/L). Cox regression analyses were performed to estimate treatment effects from each trial with hazards ratios and corresponding 95% CIs pooled with random-effects models to obtain summary treatment effects, overall and across key subgroups.
Results from 6 trials were included comprising 49 875 participants assessing 4 SGLT2 inhibitors. Of these, 1754 participants developed serious hyperkalemia, and an additional 1119 investigator-reported hyperkalemia events were recorded. SGLT2 inhibitors reduced the risk of serious hyperkalemia (hazard ratio, 0.84 [95% CI, 0.76-0.93]), an effect consistent across studies (
=0.71). The incidence of investigator-reported hyperkalemia was also lower with SGLT2 inhibitors (hazard ratio, 0.80 [95% CI, 0.68-0.93];
=0.21). Reductions in serious hyperkalemia were observed across a range of subgroups, including baseline kidney function, history of heart failure, and use of renin-angiotensin-aldosterone system inhibitor, diuretic, and mineralocorticoid receptor antagonist. SGLT2 inhibitors did not increase the risk of hypokalemia (hazard ratio, 1.04 [95% CI, 0.94-1.15];
=0.42).
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia. Hyperkalemia increases risk of cardiac arrhythmias and death and limits the use of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, which improve clinical outcomes in people with chronic kidney disease or systolic heart failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of cardiorenal events in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease. However, their effect on hyperkalemia has not been systematically evaluated.BACKGROUNDHyperkalemia increases risk of cardiac arrhythmias and death and limits the use of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, which improve clinical outcomes in people with chronic kidney disease or systolic heart failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of cardiorenal events in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease. However, their effect on hyperkalemia has not been systematically evaluated.A meta-analysis was conducted using individual participant data from randomized, double-blind, placebo-controlled clinical outcome trials with SGLT2 inhibitors in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease in whom serum potassium levels were routinely measured. The primary outcome was time to serious hyperkalemia, defined as central laboratory-determined serum potassium ≥6.0 mmol/L, with other outcomes including investigator-reported hyperkalemia events and hypokalemia (serum potassium ≤3.5 mmol/L). Cox regression analyses were performed to estimate treatment effects from each trial with hazards ratios and corresponding 95% CIs pooled with random-effects models to obtain summary treatment effects, overall and across key subgroups.METHODSA meta-analysis was conducted using individual participant data from randomized, double-blind, placebo-controlled clinical outcome trials with SGLT2 inhibitors in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease in whom serum potassium levels were routinely measured. The primary outcome was time to serious hyperkalemia, defined as central laboratory-determined serum potassium ≥6.0 mmol/L, with other outcomes including investigator-reported hyperkalemia events and hypokalemia (serum potassium ≤3.5 mmol/L). Cox regression analyses were performed to estimate treatment effects from each trial with hazards ratios and corresponding 95% CIs pooled with random-effects models to obtain summary treatment effects, overall and across key subgroups.Results from 6 trials were included comprising 49 875 participants assessing 4 SGLT2 inhibitors. Of these, 1754 participants developed serious hyperkalemia, and an additional 1119 investigator-reported hyperkalemia events were recorded. SGLT2 inhibitors reduced the risk of serious hyperkalemia (hazard ratio, 0.84 [95% CI, 0.76-0.93]), an effect consistent across studies (Pheterogeneity=0.71). The incidence of investigator-reported hyperkalemia was also lower with SGLT2 inhibitors (hazard ratio, 0.80 [95% CI, 0.68-0.93]; Pheterogeneity=0.21). Reductions in serious hyperkalemia were observed across a range of subgroups, including baseline kidney function, history of heart failure, and use of renin-angiotensin-aldosterone system inhibitor, diuretic, and mineralocorticoid receptor antagonist. SGLT2 inhibitors did not increase the risk of hypokalemia (hazard ratio, 1.04 [95% CI, 0.94-1.15]; Pheterogeneity=0.42).RESULTSResults from 6 trials were included comprising 49 875 participants assessing 4 SGLT2 inhibitors. Of these, 1754 participants developed serious hyperkalemia, and an additional 1119 investigator-reported hyperkalemia events were recorded. SGLT2 inhibitors reduced the risk of serious hyperkalemia (hazard ratio, 0.84 [95% CI, 0.76-0.93]), an effect consistent across studies (Pheterogeneity=0.71). The incidence of investigator-reported hyperkalemia was also lower with SGLT2 inhibitors (hazard ratio, 0.80 [95% CI, 0.68-0.93]; Pheterogeneity=0.21). Reductions in serious hyperkalemia were observed across a range of subgroups, including baseline kidney function, history of heart failure, and use of renin-angiotensin-aldosterone system inhibitor, diuretic, and mineralocorticoid receptor antagonist. SGLT2 inhibitors did not increase the risk of hypokalemia (hazard ratio, 1.04 [95% CI, 0.94-1.15]; Pheterogeneity=0.42).SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia.CONCLUSIONSSGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia. |
| Author | Langkilde, Anna Maria Wanner, Christoph Heerspink, Hiddo J L Perkovic, Vlado Pong, Annpey Sabatine, Marc S Neal, Bruce Raz, Itamar Mahaffey, Kenneth W Arnott, Clare Wheeler, David C Neuen, Brendon L Oshima, Megumi Agarwal, Rajiv Edwards, Robert McGuire, Darren K Toyama, Tadashi Cherney, David Z Zinman, Bernard Wiviott, Stephen D |
| Author_xml | – sequence: 1 givenname: Brendon L orcidid: 0000-0001-9276-8380 surname: Neuen fullname: Neuen, Brendon L organization: The George Institute for Global Health, University of New South Wales, Sydney, Australia (B.L.N., C.A.) – sequence: 2 givenname: Megumi surname: Oshima fullname: Oshima, Megumi organization: Department of Nephrology and Laboratory Medicine, Kanazawa University, Japan (M.O., T.T.) – sequence: 3 givenname: Rajiv orcidid: 0000-0001-8355-7100 surname: Agarwal fullname: Agarwal, Rajiv organization: Indiana University School of Medicine and VA Medical Center, Indianapolis (R.A.) – sequence: 4 givenname: Clare orcidid: 0000-0001-9370-9913 surname: Arnott fullname: Arnott, Clare organization: Sydney Medical School, University of Sydney, Australia (C.A.) – sequence: 5 givenname: David Z orcidid: 0000-0003-4164-0429 surname: Cherney fullname: Cherney, David Z organization: Department of Medicine and Department of Physiology, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada (D.Z.C.) – sequence: 6 givenname: Robert surname: Edwards fullname: Edwards, Robert organization: Janssen Research & Development, LLC, Raritan, NJ (R.E.) – sequence: 7 givenname: Anna Maria surname: Langkilde fullname: Langkilde, Anna Maria organization: AstraZeneca, Gothenburg, Sweden (A.M.L.) – sequence: 8 givenname: Kenneth W surname: Mahaffey fullname: Mahaffey, Kenneth W organization: Stanford Center for Clinical Research, Stanford University School of Medicine, CA (K.W.M.) – sequence: 9 givenname: Darren K orcidid: 0000-0002-6412-7989 surname: McGuire fullname: McGuire, Darren K organization: Department of Internal Medicine, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas (D.K.M.) – sequence: 10 givenname: Bruce orcidid: 0000-0002-0490-7465 surname: Neal fullname: Neal, Bruce organization: Department of Epidemiology and Biostatistics, Imperial College London, UK (B.N.) – sequence: 11 givenname: Vlado orcidid: 0000-0002-4257-7620 surname: Perkovic fullname: Perkovic, Vlado organization: Faculty of Medicine, University of New South Wales, Sydney, Australia (V.P.) – sequence: 12 givenname: Annpey surname: Pong fullname: Pong, Annpey organization: Merck & Co Inc, Kenilworth, NJ (A.P.) – sequence: 13 givenname: Marc S orcidid: 0000-0002-0691-3359 surname: Sabatine fullname: Sabatine, Marc S organization: TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.S.S., S.D.W.) – sequence: 14 givenname: Itamar orcidid: 0000-0003-0209-4453 surname: Raz fullname: Raz, Itamar organization: Diabetes Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel (I.R.) – sequence: 15 givenname: Tadashi orcidid: 0000-0003-0162-6286 surname: Toyama fullname: Toyama, Tadashi – sequence: 16 givenname: Christoph surname: Wanner fullname: Wanner, Christoph organization: Division of Nephrology, Department of Medicine, Würzburg University Clinic, Germany (C.W.) – sequence: 17 givenname: David C orcidid: 0000-0003-0745-3478 surname: Wheeler fullname: Wheeler, David C organization: Department of Renal Medicine, UCL Medical School, London, UK (D.C.W.) – sequence: 18 givenname: Stephen D orcidid: 0000-0002-4922-9880 surname: Wiviott fullname: Wiviott, Stephen D organization: TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.S.S., S.D.W.) – sequence: 19 givenname: Bernard surname: Zinman fullname: Zinman, Bernard organization: Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Ontario, Canada (B.Z.) – sequence: 20 givenname: Hiddo J L orcidid: 0000-0002-3126-3730 surname: Heerspink fullname: Heerspink, Hiddo J L organization: Department of Clinical Pharmacy and Pharmacology, University of Groningen, the Netherlands (H.J.L.H.) |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35394821$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNUF1v1DAQtFAR_YC_gMwbD-SwnQ8nvEUp7UU6aHVcxeNpY--ppo4dbAfp-rv6AwmiSDzNaGdmdzXn5MR5h4S842zFecU_dv22u9u0u_7ma7tuV1zwFSulzKsX5IyXosiKMm9O_uOn5DzGH4yxKpflK3KaL7OiFvyMPH3z2sxjdm1n5SPSzqcALk4-JAxU0N7dm8EkHyIFp-nWxAfqD3R9nDA8gMXRADWO3qKfLNLvJt3T3aItyUsDAyaMn2hLv2CCrHVgj9HEP_neafPL6BksvYWQjDITuEQvIQG9Cn6k2-WaH80j6g_LTy4Fby1qugsGbHxNXh4WwDfPeEHurj7vunW2ubnuu3aTqYLneaZ0KSTWQ6kVV1rLopKFhLyRAjjkQjPJJBSq4lhDqZqBwYEt_UpZq7o86EZckPd_907B_5wxpv1ookJrwaGf415URV03ZcPqxfr22ToPI-r9FMwI4bj_17T4DZBLhok |
| CitedBy_id | crossref_primary_10_1007_s12181_024_00716_6 crossref_primary_10_1093_ndt_gfae258 crossref_primary_10_1016_j_pharmthera_2022_108330 crossref_primary_10_1093_ckj_sfae237 crossref_primary_10_1007_s11897_023_00594_1 crossref_primary_10_1080_10408398_2025_2499618 crossref_primary_10_3389_fcvm_2022_1086672 crossref_primary_10_1097_MNH_0000000000000929 crossref_primary_10_1161_CIRCULATIONAHA_124_072055 crossref_primary_10_3389_fcvm_2024_1385281 crossref_primary_10_3390_jcm11143970 crossref_primary_10_1007_s11428_023_01003_w crossref_primary_10_1007_s13300_024_01550_5 crossref_primary_10_1007_s15027_024_3713_x crossref_primary_10_1016_j_jacc_2025_06_029 crossref_primary_10_1016_j_xkme_2024_100851 crossref_primary_10_1080_17512433_2025_2468954 crossref_primary_10_1007_s11428_024_01235_4 crossref_primary_10_7326_M24_0764 crossref_primary_10_1053_j_akdh_2023_01_001 crossref_primary_10_1111_dom_70026 crossref_primary_10_2215_CJN_0000000865 crossref_primary_10_3390_ijms252312941 crossref_primary_10_1093_ehjcvp_pvad081 crossref_primary_10_1093_ndt_gfae263 crossref_primary_10_3389_fphar_2022_967317 crossref_primary_10_2459_JCM_0000000000001646 crossref_primary_10_1016_S0140_6736_22_02164_X crossref_primary_10_1016_j_cardfail_2022_05_014 crossref_primary_10_1016_j_jpet_2025_103649 crossref_primary_10_1016_j_kint_2022_09_012 crossref_primary_10_1016_j_pcad_2023_10_003 crossref_primary_10_1556_650_2024_33081 crossref_primary_10_3390_ijms241813848 crossref_primary_10_3390_jcm12165184 crossref_primary_10_1053_j_akdh_2024_08_003 crossref_primary_10_1080_03007995_2025_2544594 crossref_primary_10_1007_s40265_024_02091_8 crossref_primary_10_1080_14656566_2023_2207738 crossref_primary_10_34067_KID_0000000000000468 crossref_primary_10_3389_fphar_2024_1323083 crossref_primary_10_1093_ndt_gfac198 crossref_primary_10_1093_ndt_gfaf064 crossref_primary_10_34067_KID_0000000000000561 crossref_primary_10_1016_j_beem_2024_101930 crossref_primary_10_1093_ckj_sfad249 crossref_primary_10_3390_medicina60081198 crossref_primary_10_1016_j_jacadv_2024_101131 crossref_primary_10_1016_j_eujim_2024_102365 crossref_primary_10_3389_fendo_2023_1320603 crossref_primary_10_1016_S0140_6736_23_02408_X crossref_primary_10_1093_cvr_cvad165 crossref_primary_10_1038_s41440_023_01318_7 crossref_primary_10_1093_eurheartjsupp_suac114 crossref_primary_10_1161_HYPERTENSIONAHA_123_21962 crossref_primary_10_1093_eurjpc_zwaf426 crossref_primary_10_1016_j_nefroe_2023_12_002 crossref_primary_10_1080_17446651_2022_2099373 crossref_primary_10_1093_ckj_sfaf262 crossref_primary_10_1016_j_nurpra_2024_105108 crossref_primary_10_1016_j_pharmthera_2025_108861 crossref_primary_10_1093_ndt_gfaf119 crossref_primary_10_3390_medicina59020353 crossref_primary_10_3390_ijms241814198 crossref_primary_10_2215_CJN_09380822 crossref_primary_10_1093_eurheartj_ehaf225 crossref_primary_10_1681_ASN_0000000849 crossref_primary_10_1016_j_kint_2023_11_025 crossref_primary_10_1111_dom_15518 crossref_primary_10_1159_000543923 crossref_primary_10_1111_nep_14167 crossref_primary_10_1161_JAHA_123_030142 crossref_primary_10_3390_jcm14103349 crossref_primary_10_1093_ajh_hpae092 crossref_primary_10_1002_phar_70006 crossref_primary_10_3390_ijms232213749 crossref_primary_10_1111_dom_15232 crossref_primary_10_3390_biomedicines12050981 crossref_primary_10_1080_14656566_2023_2245756 crossref_primary_10_1016_j_ahj_2023_01_002 crossref_primary_10_1016_j_cjca_2024_02_027 crossref_primary_10_1007_s10741_024_10453_3 crossref_primary_10_15829_1560_4071_2024_5772 crossref_primary_10_1093_ckj_sfae278 crossref_primary_10_1093_eurheartj_ehac304 crossref_primary_10_5646_ch_2025_31_e26 crossref_primary_10_1186_s41100_024_00523_5 crossref_primary_10_3390_jcm12082824 crossref_primary_10_1038_s41440_024_01734_3 crossref_primary_10_1161_CIRCULATIONAHA_123_067584 crossref_primary_10_1007_s11739_024_03571_1 crossref_primary_10_1093_eurheartj_ehaf258 crossref_primary_10_1007_s11906_023_01281_1 crossref_primary_10_1007_s40266_024_01165_2 crossref_primary_10_1007_s10741_023_10363_w crossref_primary_10_1016_j_kint_2022_06_013 crossref_primary_10_1016_j_semnephrol_2023_151429 crossref_primary_10_3390_jmahp12030014 crossref_primary_10_1111_dom_16371 crossref_primary_10_1016_j_ymgme_2022_07_010 crossref_primary_10_1136_bmj_2023_078483 crossref_primary_10_3390_pharmacy11020058 crossref_primary_10_1007_s12325_024_02957_z crossref_primary_10_1016_j_jacadv_2024_101024 crossref_primary_10_1093_ageing_afac201 crossref_primary_10_1080_14656566_2025_2547803 crossref_primary_10_2215_CJN_0000000000000300 crossref_primary_10_1080_00325481_2023_2256208 crossref_primary_10_1038_s41581_025_00931_8 crossref_primary_10_3390_jcm13185408 crossref_primary_10_1093_ndt_gfad112 crossref_primary_10_1093_ndt_gfad118 crossref_primary_10_1161_CIR_0000000000001209 crossref_primary_10_1161_JAHA_123_033236 crossref_primary_10_1001_jamainternmed_2025_0686 crossref_primary_10_1186_s12872_025_04704_w crossref_primary_10_1210_clinem_dgac558 crossref_primary_10_1007_s11906_024_01314_3 crossref_primary_10_1038_s41581_024_00918_x crossref_primary_10_1080_14779072_2023_2159810 crossref_primary_10_1038_s41581_024_00864_8 crossref_primary_10_1159_000543385 crossref_primary_10_3390_diagnostics14131357 crossref_primary_10_1007_s11560_023_00685_z crossref_primary_10_3389_fcvm_2023_1159953 crossref_primary_10_3390_ph17040420 crossref_primary_10_1210_endrev_bnad024 crossref_primary_10_1016_j_clinthera_2023_10_014 crossref_primary_10_1152_ajprenal_00119_2025 crossref_primary_10_2215_CJN_0000000000000150 crossref_primary_10_1002_ejhf_3800 crossref_primary_10_1038_s41440_024_01802_8 crossref_primary_10_1161_CIRCULATIONAHA_123_064346 crossref_primary_10_1038_s41581_024_00827_z crossref_primary_10_1093_ndt_gfae056 crossref_primary_10_1111_dom_16385 crossref_primary_10_1038_s41440_023_01238_6 crossref_primary_10_1002_ehf2_15293 crossref_primary_10_1093_ndt_gfad026 crossref_primary_10_1681_ASN_0000000752 crossref_primary_10_34067_KID_0000952022 crossref_primary_10_1016_j_kint_2024_12_021 crossref_primary_10_15829_1560_4071_2025_6537 crossref_primary_10_1111_bcpt_13739 crossref_primary_10_3389_fphar_2022_928121 crossref_primary_10_1007_s41969_025_00258_6 crossref_primary_10_3390_ijms24032803 crossref_primary_10_1053_j_ajkd_2023_04_015 crossref_primary_10_1016_j_cardfail_2025_07_001 crossref_primary_10_1016_j_hlc_2023_12_013 crossref_primary_10_1007_s11560_024_00821_3 crossref_primary_10_1016_j_kint_2023_10_018 crossref_primary_10_1055_a_2481_2004 crossref_primary_10_1159_000542621 crossref_primary_10_1053_j_jvca_2025_06_015 crossref_primary_10_1038_s41581_024_00836_y crossref_primary_10_1093_ndt_gfac322 crossref_primary_10_4239_wjd_v13_i7_471 crossref_primary_10_59556_japi_72_0759 crossref_primary_10_1080_14796678_2025_2503666 crossref_primary_10_2215_CJN_0000000000000205 crossref_primary_10_1093_ndt_gfae227 crossref_primary_10_1681_ASN_0000000000000248 crossref_primary_10_3389_fvets_2025_1480977 crossref_primary_10_1161_CIR_0000000000001303 crossref_primary_10_1056_NEJMoa2410659 crossref_primary_10_1093_eurheartj_ehad522 crossref_primary_10_1016_S2213_8587_23_00322_4 crossref_primary_10_1016_j_biomaterials_2022_121844 crossref_primary_10_1016_j_hlc_2025_05_095 crossref_primary_10_1093_ndt_gfaf160 crossref_primary_10_1007_s11906_023_01265_1 crossref_primary_10_1053_j_ajkd_2024_08_003 crossref_primary_10_3389_fphar_2024_1462965 crossref_primary_10_1152_ajprenal_00240_2023 crossref_primary_10_1001_jamainternmed_2024_3806 |
| ContentType | Journal Article |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1161/CIRCULATIONAHA.121.057736 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine Anatomy & Physiology |
| EISSN | 1524-4539 |
| ExternalDocumentID | 35394821 |
| Genre | Meta-Analysis Journal Article |
| GroupedDBID | --- .-D .3C .XZ .Z2 01R 0R~ 0ZK 18M 1J1 29B 2FS 2WC 354 40H 4Q1 4Q2 4Q3 53G 5GY 5RE 5VS 6PF 71W 77Y 7O~ AAAAV AAAXR AAGIX AAHPQ AAIQE AAJCS AAMOA AAMTA AAQKA AARTV AASCR AASOK AASXQ AAUEB AAWTL AAXQO ABASU ABBUW ABDIG ABJNI ABOCM ABPMR ABQRW ABVCZ ABXVJ ABZAD ACDDN ACEWG ACGFO ACGFS ACIJW ACILI ACLDA ACOAL ACRKK ACWDW ACWRI ACXJB ACXNZ ADBBV ADCYY ADGGA ADHPY AE3 AE6 AEBDS AENEX AFCHL AFDTB AFEXH AFSOK AFUWQ AGINI AHMBA AHOMT AHQNM AHRYX AHVBC AIJEX AINUH AJCLO AJIOK AJNWD AJZMW AKCTQ AKULP ALKUP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW ASPBG AVWKF AWKKM AYCSE AZFZN BAWUL BOYCO BQLVK BYPQX C45 CGR CS3 CUY CVF DIK DIWNM DU5 E3Z EBS ECM EEVPB EIF ERAAH EX3 F2K F2L F2M F2N F5P FCALG GNXGY GQDEL GX1 H0~ HLJTE HZ~ IKREB IKYAY IN~ IPNFZ JF9 JG8 JK3 K-A K-F K8S KD2 KMI KQ8 L-C L7B N9A NPM N~7 N~B O9- OAG OAH OBH OCB ODA ODMTH OGEVE OHH OHYEH OJAPA OK1 OL1 OLB OLG OLH OLU OLV OLW OLY OLZ OPUJH OVD OVDNE OVIDH OVLEI OVOZU OWBYB OWU OWV OWW OWX OWY OWZ OXXIT P2P PQQKQ RAH RHF RIG RLZ S4R S4S T8P TEORI TR2 TSPGW UPT V2I VVN W2D W3M W8F WH7 WOQ WOW X3V X3W XXN XYM YFH YOC YSK YYM YZZ ZFV ZY1 ~H1 7X8 AAFWJ ABPXF ABXYN ABZZY ACDOF ACZKN ADKSD ADSXY AFBFQ AFMBP AFNMH AHQVU AOQMC |
| ID | FETCH-LOGICAL-c4133-cd527e8b5dc1cdd746747a3972a1a32d0707a4c61e8a5c9b0af0116778c85fd92 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 214 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=00003017-990000000-00023&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1524-4539 |
| IngestDate | Mon Sep 08 05:10:59 EDT 2025 Wed Feb 19 02:26:35 EST 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 19 |
| Keywords | heart failure sodium-glucose transporter 2 inhibitors potassium type 2 renal insufficiency hyperkalemia diabetes mellitus chronic |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c4133-cd527e8b5dc1cdd746747a3972a1a32d0707a4c61e8a5c9b0af0116778c85fd92 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ORCID | 0000-0002-6412-7989 0000-0001-9276-8380 0000-0001-8355-7100 0000-0003-4164-0429 0000-0002-3126-3730 0000-0003-0209-4453 0000-0003-0162-6286 0000-0002-4257-7620 0000-0002-0490-7465 0000-0002-0691-3359 0000-0002-4922-9880 0000-0003-0745-3478 0000-0001-9370-9913 |
| OpenAccessLink | https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.121.057736 |
| PMID | 35394821 |
| PQID | 2648895908 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2648895908 pubmed_primary_35394821 |
| PublicationCentury | 2000 |
| PublicationDate | 2022-05-10 |
| PublicationDateYYYYMMDD | 2022-05-10 |
| PublicationDate_xml | – month: 05 year: 2022 text: 2022-05-10 day: 10 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Circulation (New York, N.Y.) |
| PublicationTitleAlternate | Circulation |
| PublicationYear | 2022 |
| SSID | ssj0006375 |
| Score | 2.703985 |
| SecondaryResourceType | review_article |
| Snippet | Hyperkalemia increases risk of cardiac arrhythmias and death and limits the use of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 1460 |
| SubjectTerms | Antihypertensive Agents - therapeutic use Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Female Glucose Humans Hyperkalemia - chemically induced Hyperkalemia - epidemiology Hypokalemia - chemically induced Hypokalemia - epidemiology Male Mineralocorticoid Receptor Antagonists - adverse effects Potassium Randomized Controlled Trials as Topic Renal Insufficiency, Chronic - drug therapy Renal Insufficiency, Chronic - epidemiology Sodium Sodium-Glucose Transporter 2 Inhibitors - adverse effects |
| Title | Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/35394821 https://www.proquest.com/docview/2648895908 |
| Volume | 145 |
| WOSCitedRecordID | wos00003017-990000000-00023&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1bb9MwFLaAoYkXLhuXcdOZhHgirLHjOuEFVYHSSmtVlQ36Vjm2o1kjzmgyJPhd_ECOnXR7QkJCivJmxZGPfW6fv4-QV7j9C4GBQVRSL2HGOY-KWOhowLKUJZqJQdBP-XIs5vN0tcoWfcGt6WGV2zMxHNS6Vr5GfuSRWGnmFbrfX3yPvGqU7672Eho3yQ7DUMZbtVhds4UPWSDaRReV4DRYtksOwyExjI_y6TI_Pe4IZye-Ihi_xchFsOHfI83gccb3_neu98ndPtaEUWccD8gN4_bI_shhnl39hNcQ0J-hrL5Hdmd9k32f_P5ca3tZRZ86NDvkdXvFgL4BClN3ZgvrVXpAOg1L25xDXcIEM9rNOfqbykqwDhYBmw5fbXsGPtvFkT38pnkHI5iZVkZbShQ_fnp1NQwWsgd7uxY-yFbCeFNXsMSv1ZX9ZfQbyDuE_Tej4SRsoYfkdPzxJJ9EvbhDpNBvskhpToVJC65VrLQOqidCYnREZSwZ1Z6GSCZqGJtUcpUVA1mGnpFIVcpLndFH5JarnXlCoCgFT0ypFZUiKbjAx0hqSkMzzJ6MPCCH22Va4-bxHRHpTH3ZrK8X6oA87tZ6fdGxfKwZGkyS0vjpP4x-Ru5Qfy0isLo-Jzsl_rd5QW6rH61tNi-DVeJ7vpj9AffH7Ug |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Sodium-Glucose+Cotransporter+2+Inhibitors+and+Risk+of+Hyperkalemia+in+People+With+Type+2+Diabetes%3A+A+Meta-Analysis+of+Individual+Participant+Data+From+Randomized%2C+Controlled+Trials&rft.jtitle=Circulation+%28New+York%2C+N.Y.%29&rft.au=Neuen%2C+Brendon+L&rft.au=Oshima%2C+Megumi&rft.au=Agarwal%2C+Rajiv&rft.au=Arnott%2C+Clare&rft.date=2022-05-10&rft.eissn=1524-4539&rft.volume=145&rft.issue=19&rft.spage=1460&rft_id=info:doi/10.1161%2FCIRCULATIONAHA.121.057736&rft_id=info%3Apmid%2F35394821&rft_id=info%3Apmid%2F35394821&rft.externalDocID=35394821 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1524-4539&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1524-4539&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1524-4539&client=summon |