The Effect of short-term SGLT2 Inhibitors therapy on the Development of Contrast-induced acute kidney injury in Diabetic Patients undergoing Coronary computed tomographic angiography：a prospective study

Introduction : Notably, SGLT2 inhibitors are renowned for their renal protective properties. However, empirical evidence regarding their efficacy in mitigating CI-AKI risk during Coronary computed tomographic angiography(CCTA) in diabetic cohorts remains scarce. Methods : This research conducted a double blind randomized clinical trial involving 352 patients undergoing CCTA. Participants were randomly assigned to receive SGLT2i (treatment group) or a placebo（control group）, starting 3 days before CCTA. The patients’ serum creatinine levels were evaluated at before and after the procedure. Univariate and multivariate logistic regression analyses were performed to assess the associations of demographic, clinical, and procedural characteristics with CI-AKI. Results: Finally, 161 patients entered each group, two groups patients had no significant demographic and clinical data differences before CCTA. We showed that the incidence of CI- AKI was meaningfully lower in the treatment group (5.15%) than in the control group (13.88%, P = 0.024).Univariate and multivariate regression analysis showed that SGLT2i significantly lowered the rate of CI-AKI [odds ratio(OR)=0.242], increasing Age (OR=1.070), high BNP level (OR=1.001), and high homocysteine values (OR=1.053) were positively correlated with CI- AKI (all p<0.05). Conclusion : Observations obtained from this investigation indicate that the use of SGLT2 inhibitors could be protective against the occurrence of CI-AKI in diabetic patients undergoing CCTA.