Purpose
To investigate the association of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors and acute kidney injury in comparison to other classes of drugs.
Patients and Methods
A total of 4966 diabetes mellitus patients were investigated for developing Acute Kidney Injury (AKI) who were under prescription with the following class of drugs viz. SGLT2 Inhibitors, Dipeptidyl peptidase-4 (DDP4) inhibitors, Nonsteroidal anti-inflammatory drugs (NSAIDs), first-line drugs and anti-biotics. The primary outcome was based on the hospital encounter and Kidney Disease Improving Global Outcome (KDIGO) threshold values were used to assess the serum creatinine concentration. The secondary outcome was assessed based on the concentration level of serum creatinine after 90 days of hospital admission and evaluation of the KDIGO threshold values.
Results
The study observed that the risk of causing AKI for SGLT2 inhibitors was 5.59% which was comparatively low compared to other class of the investigated drugs (DPP4 inhibitors = 6.47%, antibiotics = 6.30%, first-line drugs = 6.82% and NSAIDs = 10.65%). The multivariate analysis observed that ibuprofen, celecoxib, indomethacin, insulin, cephalexin, and alogliptin were mostly associated with an increased rate of AKI. SGLT2 inhibitors have the lowest risk for developing AKI compared to other drugs and control.
Conclusion
AKI incidence is relatively low after initiation of SLGT2 inhibitors and concludes that regulatory warnings from certain health agencies about its risk for AKI on prescription are unwarranted.
A regioselective hydroboration/hydrolysis of epoxides with pinacolborane catalyzed by NaOH/BEt 3 was achieved. Glycidyl oxide, styrene oxide and adamantane epoxide underwent facile hydroboration/deprotection to provide secondary alcohols with exclusive selectivity in good to excellent yields. Moreover, the stereochemistry of epoxides could also be well retained, and the corresponding secondary alcohols were obtained with high optical activity under alkaline catalysis. Significantly, in this reaction, diverse functional groups can be compatible, including hydrogenation-sensitive groups, such as carbon-carbon double bonds and halogens.
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