Burçak Cavnar HELVACI, Ayşegül KARAOĞLAN, Hatice PAŞAOĞLU
The Journal of European Internal Medicine Professionals - 2026;4(1):1-6
Background: Chronic kidney disease (CKD) is characterized by systemic inflammation that contributes to cardiovascular morbidity. The Aggregate Index of Systemic Inflammation (AISI), calculated as (neutrophils x platelets x monocytes)/ lymphocytes, has emerged as a prognostic biomarker. SGLT-2 inhibitors demonstrate anti-inflammatory properties in CKD, yet their impact on AISI remains unexplored. We aim to evaluate the impact of SGLT-2 inhibitor therapy on AISI values in patients with stage 3-4 CKD and type 2 diabetes mellitus. Methods: This retrospective cohort study included 148 patients with stage 3-4 CKD and type 2 diabetes mellitus who initiated SGLT-2 inhibitor therapy at Gazi University Nephrology Clinic between September 2024 and September 2025. AISI was calculated from complete blood counts at baseline and follow-up (mean 48.0 +/- 12.2 days). The primary outcome was change in AISI values. Paired t-test was used for statistical analysis. Results: Mean age was 67.15 +/- 9.20 years, 54.7% were male, and baseline eGFR was 38.9 +/- 12.1 mL/min/1.73m². Patients received empagliflozin (n=74) or dapagliflozin (n=74). AISI showed no significant change from baseline to follow-up indicating no significant difference (519.89 +/- 319.52 vs. 503.15 +/- 442.39, p=0.535). Conclusions: SGLT-2 inhibitor therapy does not significantly alter AISI values in stage 3-4 CKD patients with diabetes over short-term follow-up. The established cardiovascular and renal benefits of SGLT-2 inhibitors appear to operate through mechanisms not reflected in this composite inflammatory marker.
