Chen, Jui-YiJui-YiChenChuang, Min-HsiangMin-HsiangChuangLai, Hsuan-WenHsuan-WenLaiVIN-CENT WU2025-07-092025-07-092025-06-26https://scholars.lib.ntu.edu.tw/handle/123456789/730635Aims: To evaluate the effectiveness of combined therapy of Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP-1RAs) versus monotherapy in patients with type 2 diabetes mellitus (T2DM) and acute kidney disease (AKD). Methods: This cohort study used TriNetX from adults with T2DM and AKD, treated with either SGLT2i, GLP-1RAs, or both from 2012 to 2023. Outcomes were all-cause mortality, major adverse kidney events (MAKE), and major adverse cardiovascular events (MACE). Results: Among 29,269 patients, 1,591 (5.4 %) received combined therapy, 6,327 in the SGLT2i group, and 5,968 in the GLP-1RAs group. The combined group had significantly lower risks of all-cause mortality compared to SGLT2i monotherapy (aHR = 0.53) and GLP-1RAs monotherapy (aHR = 0.43) after a mean follow-up of 2.4 years. The combined group showed lower risks of MAKE compared to SGLT2i monotherapy (aHR = 0.70) and GLP-1RAs monotherapy (aHR = 0.45) after a mean follow-up of 2.7 years. MACE risk was similar across groups. The combined group had a higher risk of hypoglycemia (aHR = 1.51), diabetic retinopathy (aHR = 1.59) compared to the SGLT2i monotherapy group. Conclusions: Combined SGLT2i and GLP-1RA therapy offers better survival and kidney protection but requires careful monitoring for hypoglycemia and retinopathy.enCombinationGlucagon-Like Peptide-1 Receptor AgonistsMortalitySodium-glucose cotransporter 2 inhibitorsjournal article10.1016/j.diabres.2025.11233940581158