---
title: "SGLT2 Inhibitors and Infection Outcomes in CKD Patients with Type 2 Diabetes: Sepsis, Mortality, a"
id: "pubmed-42711252"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42711252"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42711252/"
doi: "10.23876/j.krcp.26.134"
published_at: "2026-09-09T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# SGLT2 Inhibitors and Infection Outcomes in CKD Patients with Type 2 Diabetes: Sepsis, Mortality, a
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42711252
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42711252/)
- **DOI:** [10.23876/j.krcp.26.134](https://doi.org/10.23876%2Fj.krcp.26.134)
- **Published At:** 2026-09-09T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This real-world, active-comparator, new-user cohort study used the U.S. Collaborative Network of TriNetX to compare outcomes after initiation of **SGLT-2 inhibitors** versus **DPP-4 inhibitors** in adults with chronic kidney disease (CKD) and type 2 diabetes (T2D). - Propensity score matching produced two balanced groups of 25,049 patients each, with 1 year of follow-up after drug initiation. - The primary outcome was **severe sepsis**. SGLT-2 inhibitor use was associated with a lower incidence of severe sepsis versus DPP-4 inhibitors (2.7% vs. 3.3%; HR 0.81; 95% CI 0.73–0.90). - Secondary outcomes with reduced risks for SGLT-2 inhibitors included septic shock (HR 0.83), all-cause mortality (HR 0.72), hospitalization (HR 0.90), pneumonia (HR 0.77), and urinary tract infection (UTI) (HR 0.72). - SGLT-2 inhibitor use carried a higher risk of genital infection (HR 1.93); no significant differences were reported for diabetic ketoacidosis or acidosis. - The authors conclude SGLT-2 inhibitors were associated with lower risks of severe sepsis, infection-related complications, hospitalization, and mortality in this high-risk population, despite increased genital infection risk, supporting their broader benefit beyond cardiorenal protection. - Keywords highlighted in the study include **Pneumonia**, **Sepsis**, **Sodium-glucose transporter 2 inhibitors**, and **Urinary tract infections**.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Sodium-glucose cotransporter-2 inhibitors, severe sepsis, and infection-related outcomes in patients with chronic kidney disease and type 2 diabetes [Chung-An Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+CA&cauthor_id=42711252)[#](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-1 "Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan."), [Wei-Jie Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+WJ&cauthor_id=42711252)[#](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Lo-Sheng Sanatorium and Hospital, Ministry of Health and Welfare, New Taipei, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-3 "Department of Biomedical Engineering, Chung Yuan Christian University, Chungli, Taiwan."), [Jui-Yi Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+JY&cauthor_id=42711252)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-4 "Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-5 "Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Yen-Heng Tseng](https://pubmed.ncbi.nlm.nih.gov/?term=Tseng+YH&cauthor_id=42711252)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-6 "Taipei Wego Private Senior High School, Taipei, Taiwan."), [Chung-Yi Cheng](https://pubmed.ncbi.nlm.nih.gov/?term=Cheng+CY&cauthor_id=42711252)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-7 "Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-8 "Taipei Medical University-Research Center of Urology and Kidney, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan."), [Vin-Cent Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+VC&cauthor_id=42711252)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-9 "Primary Aldosteronism Center of Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. q91421028@ntu.edu.tw.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#full-view-affiliation-10 "National Taiwan University Hospital Study Group of Acute Renal Failure and Taiwan Consortium for Acute Kidney Injury and Renal Diseases, Taipei, Taiwan. q91421028@ntu.edu.tw.") Affiliations Expand ### Affiliations * 1 Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. * 2 Division of Nephrology, Department of Internal Medicine, Lo-Sheng Sanatorium and Hospital, Ministry of Health and Welfare, New Taipei, Taiwan. * 3 Department of Biomedical Engineering, Chung Yuan Christian University, Chungli, Taiwan. * 4 Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan. * 5 Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 6 Taipei Wego Private Senior High School, Taipei, Taiwan. * 7 Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. * 8 Taipei Medical University-Research Center of Urology and Kidney, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * 9 Primary Aldosteronism Center of Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. q91421028@ntu.edu.tw. * 10 National Taiwan University Hospital Study Group of Acute Renal Failure and Taiwan Consortium for Acute Kidney Injury and Renal Diseases, Taipei, Taiwan. q91421028@ntu.edu.tw. # Contributed equally. * PMID: **42711252** * DOI: [ 10.23876/j.krcp.26.134 ](https://doi.org/10.23876/j.krcp.26.134) Item in Clipboard # Sodium-glucose cotransporter-2 inhibitors, severe sepsis, and infection-related outcomes in patients with chronic kidney disease and type 2 diabetes Chung-An Wang et al. Kidney Res Clin Pract. 2026. Show details Display options Display options Format Abstract PubMed PMID Kidney Res Clin Pract Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Kidney+Res+Clin+Pract%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Kidney+Res+Clin+Pract%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42711252/) . 2026 Sep 9. doi: 10.23876/j.krcp.26.134. Online ahead of print. ### Authors [Chung-An Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+CA&cauthor_id=42711252)[#](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-1 "Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan."), [Wei-Jie Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+WJ&cauthor_id=42711252)[#](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Lo-Sheng Sanatorium and Hospital, Ministry of Health and Welfare, New Taipei, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-3 "Department of Biomedical Engineering, Chung Yuan Christian University, Chungli, Taiwan."), [Jui-Yi Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+JY&cauthor_id=42711252)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-4 "Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-5 "Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Yen-Heng Tseng](https://pubmed.ncbi.nlm.nih.gov/?term=Tseng+YH&cauthor_id=42711252)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-6 "Taipei Wego Private Senior High School, Taipei, Taiwan."), [Chung-Yi Cheng](https://pubmed.ncbi.nlm.nih.gov/?term=Cheng+CY&cauthor_id=42711252)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-7 "Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-8 "Taipei Medical University-Research Center of Urology and Kidney, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan."), [Vin-Cent Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+VC&cauthor_id=42711252)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-9 "Primary Aldosteronism Center of Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. q91421028@ntu.edu.tw.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42711252/#short-view-affiliation-10 "National Taiwan University Hospital Study Group of Acute Renal Failure and Taiwan Consortium for Acute Kidney Injury and Renal Diseases, Taipei, Taiwan. q91421028@ntu.edu.tw.") ### Affiliations * 1 Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. * 2 Division of Nephrology, Department of Internal Medicine, Lo-Sheng Sanatorium and Hospital, Ministry of Health and Welfare, New Taipei, Taiwan. * 3 Department of Biomedical Engineering, Chung Yuan Christian University, Chungli, Taiwan. * 4 Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan. * 5 Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 6 Taipei Wego Private Senior High School, Taipei, Taiwan. * 7 Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. * 8 Taipei Medical University-Research Center of Urology and Kidney, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * 9 Primary Aldosteronism Center of Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. q91421028@ntu.edu.tw. * 10 National Taiwan University Hospital Study Group of Acute Renal Failure and Taiwan Consortium for Acute Kidney Injury and Renal Diseases, Taipei, Taiwan. q91421028@ntu.edu.tw. # Contributed equally. * PMID: **42711252** * DOI: [ 10.23876/j.krcp.26.134 ](https://doi.org/10.23876/j.krcp.26.134) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) are vulnerable to infections. While sodium-glucose cotransporter-2 (SGLT-2) inhibitors provide established cardiorenal benefits, their effects on infection remain unclear. This study aimed to evaluate the association between SGLT-2 inhibitors and the risks of severe sepsis, infection-related complications, and mortality in this population. **Methods:** We conducted a real-world, active-comparator, new-user cohort study using the U.S. Collaborative Network of TriNetX. Adults with CKD and T2D who initiated SGLT-2 inhibitors or DPP-4 inhibitors between 2018 and 2024 were included. Propensity score matching was applied to balance baseline characteristics. The primary outcome was severe sepsis; secondary outcomes included septic shock, mortality, hospitalization, pneumonia, urinary tract infection (UTI), and genital infection. **Results:** After matching, 25,049 patients were included in each group. During 1 year of follow-up, SGLT-2 inhibitor use was associated with a lower risk of severe sepsis than DPP-4 inhibitor use (2.7% vs. 3.3%; HR, 0.81; 95% CI, 0.73-0.90). Risks of septic shock (HR, 0.83), mortality (HR, 0.72), hospitalization (HR, 0.90), pneumonia (HR, 0.77), and UTI (HR, 0.72) were reduced, whereas the risk of genital infection (HR, 1.93) was higher. No significant differences were observed in diabetic ketoacidosis or acidosis. **Conclusion:** Among patients with CKD and T2D, SGLT-2 inhibitor initiation was associated with lower risks of severe sepsis, infection-related outcomes, hospitalization, and mortality compared with DPP-4 inhibitor initiation, despite a higher risk of genital infection. These findings support SGLT-2 inhibitors as a core therapy with potential benefits extending beyond cardiorenal protection in this high-risk population. **Keywords:** Pneumonia; Sepsis; Sodium-glucose transporter 2 inhibitors; Urinary tract infections. 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