SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria

Do the kidney protective effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors vary by estimated glomerular filtration rate (eGFR) or albuminuria?In this meta-analysis that included 70 361 participants in 10 trials of SGLT2 inhibitors vs placebo, SGLT2 inhibitors significantly reduced progression of chronic kidney disease (CKD), serious acute kidney injury, and kidney failure. The relative risk reduction for CKD progression was consistent regardless of eGFR and albuminuria. Significant reductions in the annual rate of eGFR decline were observed across all subgroups, including when participants with and without diabetes were analyzed separately.These findings support the routine use of SGLT2 inhibitors to improve kidney outcomes across the full spectrum of kidney function and albuminuria among patients with type 2 diabetes, CKD, or heart failure.

Corresponding Author: Brendon L. Neuen, PhD (bneuen@georgeinstitute.org.au), and Hiddo J. L. Heerspink, PhD (h.j.lambers.heerspink@umcg.nl), SMART-C Secretariat, The George Institute for Global Health, University of New South Wales, Level 8, 55 Botany St, Randwick, Sydney, NSW 2031, Australia.

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