Table 3.
Multivariable logistic regression model exploring factors associated with SGLT2 inhibitor prescribing in CKD-T2D cohort meeting guideline directed indications for SGLT2 inhibitor treatment.
| Variable | n prescribed SGLT2i/N indicated | Percentage indicated prescribed SGLT2i, % | Unadjusted Odds Ratio (95% CI) | p-value | Multivariable Model 1a Odds Ratio (95% CI) | p-value | Multivariable Model 2b Odds Ratio (95% CI) | p-value |
|---|---|---|---|---|---|---|---|---|
| Age (years) | 23,464/106,468 | 22.04 | 0.94 (0.94–0.95) | <0.0001 | 0.95 (0.95–0.95) | <0.0001 | – | – |
| Sex | ||||||||
| Male | 15,716/60,552 | 25.95 | 1.0 (Reference) | – | – | |||
| Female | 7748/45,916 | 16.87 | 0.58 (0.56–0.60) | <0.0001 | 0.69 (0.67–0.72) | <0.0001 | – | – |
| Ethnicity | ||||||||
| White | 19,077/89,928 | 21.21 | 1.0 (Reference) | 1.0 (Reference) | – | – | ||
| Asian | 2982/10,386 | 28.71 | 1.50 (1.43–1.57) | <0.0001 | 1.06 (1.00–1.12) | 0.033 | – | – |
| Black | 920/4306 | 21.37 | 1.01 (0.94–1.09) | 0.81 | 0.84 (0.77–0.91) | <0.0001 | – | – |
| Mixed | 242/946 | 25.58 | 1.28 (1.10–1.48) | 0.0011 | 0.97 (0.82–1.14) | 0.69 | – | – |
| Other | 243/902 | 26.94 | 1.37 (1.18–1.59) | <0.0001 | 1.10 (0.93–1.31) | 0.26 | – | – |
| IMD quintile | ||||||||
| 5 (least deprived) | 4113/19,402 | 21.20 | 1.0 (Reference) | |||||
| 4 | 4662/21,563 | 21.62 | 1.03 (0.98–1.08) | 0.30 | 0.94 (0.89–0.99) | 0.026 | – | – |
| 3 | 4577/21,254 | 21.53 | 1.02 (0.97–1.07) | 0.41 | 0.85 (0.81–0.90) | <0.0001 | – | – |
| 2 | 4902/22,167 | 22.11 | 1.06 (1.01–1.11) | 0.024 | 0.78 (0.74–0.82) | <0.0001 | – | – |
| 1 (most deprived) | 5210/22,082 | 23.59 | 1.15 (1.10–1.20) | <0.0001 | 0.72 (0.68–0.76) | <0.0001 | – | – |
| eGFR mL/min/1.73 m2 | ||||||||
| ≥60 | 17,575/64,886 | 27.09 | 1.0 (Reference) | – | – | 1.0 (Reference) | ||
| ≥45 to <60 | 3657/26,431 | 13.84 | 0.43 (0.42–0.45) | <0.0001 | – | – | 0.65 (0.62–0.68) | <0.0001 |
| ≥30 to <45 | 1905/12,470 | 15.28 | 0.49 (0.46–0.51) | <0.0001 | – | – | 0.73 (0.69–0.78) | <0.0001 |
| ≥15 to <30 | 325/2447 | 13.28 | 0.41 (0.37–0.47) | <0.0001 | – | – | 0.52 (0.46–0.60) | <0.0001 |
| <15 | 2/234 | 0.85 | 0.06 (0.01–0.39) | 0.0086 | – | – | 0.03 (0.00–0.23) | 0.004 |
| Urine ACR mg/mmol | ||||||||
| <3 | 9646/47,071 | 20.49 | 1.0 (Reference) | – | – | 1.0 (Reference) | ||
| ≥3 to ≤30 | 10,263/46,797 | 21.93 | 1.09 (1.06–1.13) | <0.0001 | – | – | 0.78 (0.75–0.82) | <0.0001 |
| >30 | 3555/12,600 | 28.21 | 1.53 (1.44–1.61) | <0.0001 | – | – | 1.08 (1.01–1.15) | 0.020 |
| Co-morbidities | ||||||||
| CVD | ||||||||
| Absent | 15,562/70,634 | 22.03 | 1.0 (Reference) | – | – | 1.0 (Reference) | ||
| Present | 7902/35,834 | 22.05 | 1.00 (0.97–1.03) | 0.94 | – | – | 1.08 (1.04–1.12) | 0.0001 |
| Heart failure | ||||||||
| Absent | 17,012/87,824 | 19.37 | 1.0 (Reference) | – | – | 1.0 (Reference) | ||
| Present | 6452/18,644 | 34.61 | 2.20 (2.13–2.28) | <0.0001 | – | – | 3.59 (3.42–3.77) | <0.001 |
CVD—cardiovascular disease, IMD—index of multiple deprivation, eGFR—estimated glomerular filtration rate, urine ACR—urine albumin-to-creatinine ratio, HbA1c—glycated haemoglobin, BMI—body mass index, CI—confidence interval, SGLT2i—sodium-glucose co-transporter 2 inhibitor, CKD—chronic kidney disease, T2D—type 2 diabetes. CVD defined as ischaemic heart disease, stroke, and peripheral arterial disease.
Multivariable model 1 includes the following covariates: age (years), sex (male, female), ethnicity (White, Asian, Black Mixed, Other), IMD quintile (IMD quintile 1–5), BMI category (<18.5 kg/m2, ≥18.5–<25 kg/m2, ≥25–<30 kg/m2, ≥30–<35 kg/m2, ≥35–<40 kg/m2, ≥40 kg/m2), HbA1c category (<53 mmol/mol, ≥53–<64 mmol/mol, ≥64–<75 mmol/mol, ≥75–<85 mmol/mol, ≥85 mmol/mol), eGFR category (≥60 mL/min/1.73 m2, 45–59 mL/min/1.73 m2, 30–44 mL/min/1.73 m2, 15–29 mL/min/1.73 m2, <15 mL/min/1.73 m2), urine ACR category (<3 mg/mmol, 3–30 mg/mmol, >30 mg/mmol), cardiovascular disease (absent, present), heart failure (absent, present), and hypertension (absent, present).
Multivariable model 2 includes the covariates in model 1 in addition to duration of type 2 diabetes (years) and diuretic prescription (absent, present). N = 106,468.