# Glucosurie duidt op adherence aan SGLT2-remmers en correleert met minder sterfte en hartfalen

*geplaatst 2026-09-25 · Hartfalen · Journal of the American Society of Nephrology : JASN · doi 10.1681/ASN.0000001252 · https://hartvaat.nl/2026/09/17/glucosurie-duidt-op-adherence-aan-sglt2-remmers-en-correleert-met-minder-sterfte/*

Een real-world cohortstudie van bijna 46.000 patiënten onderzocht of glucosurie op het urinedipstick een bruikbare proxy is voor adherence aan SGLT2-remmers. Patiënten met glucosurie (≥2+) hadden na correctie voor confounders een lager risico op all-cause sterfte (HR 0,78), hartfalenhospitalisatie (HR 0,87) en eindstadia nierfalen (HR 0,73) vergeleken met patiënten zonder glucosurie. Dit suggereert dat een eenvoudige urinedipstick een praktische controle kan zijn op het daadwerkelijk innemen van deze cardiorenale standaardmedicatie, zonder verhoogd fractuurrisico.

## English: Glucosuria as a Marker of Adherence to Sodium-Glucose Cotransporter 2 Inhibitors and Clinical Outcomes in Real-World Practice.

A real-world cohort study of nearly 46,000 patients evaluated whether glucosuria on routine urinalysis serves as a practical proxy for adherence to SGLT2 inhibitors. After inverse probability weighting, patients with glucosuria (≥2+) had significantly lower risks of all-cause mortality (HR 0.78), heart failure hospitalization (HR 0.87), and end-stage kidney disease (HR 0.73) compared to those without glucosuria, with no increase in fractures. These findings suggest that simple urinalysis could be a useful, low-cost tool to verify medication adherence in routine practice, reinforcing the real-world effectiveness of SGLT2 inhibitors in cardiorenal care.

## Abstract (original, from the publication)

BACKGROUND: Medication non-adherence contributes to the efficacy-effectiveness gap in real-world practice. Glucosuria, routinely measured on urinalysis, may serve as an objective proxy for assessing medication adherence to sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of medications that reduce the risks of kidney disease, heart failure, and mortality. METHODS: We leveraged two cohorts from the Optum Labs Data Warehouse real-world data (2014-2023): Cohort 1 included 3,987 patients with SGLT2 inhibitor pharmacy claims and a urinalysis performed both before and during active fill periods; cohort 2 included 45,711 patients prescribed SGLT2 inhibitors with urinalysis performed within 6 months after initiation. Glucosuria was defined as urine glucose 2+ or greater. Cohort 2 was followed for a mean of 3.3 years for all-cause mortality, heart failure hospitalization, end-stage kidney disease; fractures were used as a negative control outcome. RESULTS: In cohort 1, SGLT2 inhibitor use (vs. no use) was associated with 18.1-fold higher odds of glucosuria (95% CI, 16.4-20.0), adjusted for diabetes status. In cohort 2, 26,657 (58%) had glucosuria within 6 months of SGLT2 inhibitor initiation, suggesting adherence. After inverse probability of treatment weighting, glucosuria was associated with lower risks of all-cause mortality (HR, 0.78; 95% CI, 0.73-0.83), heart failure hospitalization (HR, 0.87; 95% CI, 0.78-0.98), and end-stage kidney disease (HR, 0.73; 95% CI, 0.58-0.91) compared to no glucosuria. No association was observed with fractures (HR, 1.00; 95% CI, 0.95-1.06). CONCLUSIONS: Glucosuria was associated with SGLT2 inhibitor adherence and, among patients prescribed SGLT2 inhibitors, is associated with reductions in risks of all-cause mortality, heart failure, and end-stage kidney disease.

Auteurs: Zongpu Li, Aditya Surapaneni, David M Charytan, Leora Horwitz, Saul Blecker, Jung-Im Shin, Lorna E Thorpe, Michal Melamed, Morgan E Grams

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Bron: Journal of the American Society of Nephrology : JASN, https://doi.org/10.1681/ASN.0000001252. Bijgewerkt 2026-09-18T01:27:11Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.