In this retrospective cohort of Malaysian patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), initiation of SGLT2 inhibitor was associated with a modest early decline of estimated glomerular filtration rate (eGFR) that stabilized over 12 months. Glycemic control improved, and changes in eGFR were not linked to HbA1c.

Chronic kidney disease (CKD) has a significant global impact, affecting over 800 million people, particularly those from lower socio-economic backgrounds. In Hong Kong, recent survey data indicate that 0.7% of individuals aged 15 and older have been diagnosed with renal impairment.1 CKD is classified into five stages, with stages 4 and 5 linked to considerably higher risks of mortality and cardiovascular complications. Early detection and intervention are crucial for preventing the progression to kidney failure and for effective risk stratification, especially since over 40% of individuals with diabetes—a major risk factor for CKD—are likely to develop the condition.

Hyperkalemia, defined as serum potassium >5.0mmol/L, is a potentially lethal condition as it hinders muscle function and myocardial excitability, which may contribute to arrhythmias and sudden cardiac deaths. Epidemiological data suggests the global prevalence of hyperkalemia is around 6.3%, but the