Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria

What are the relative and absolute effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors in large trials that were stratified by a urine albumin to creatinine ratio (UACR) threshold of 200 mg/g after stratifying by diabetes status?In this meta-analysis that included 58 816 participants from 8 trials of SGLT2 inhibitors vs placebo, there were net absolute benefits across efficacy outcomes (particularly hospital admission) among participants with vs without diabetes and at both levels of albuminuria (UACR ≥200 mg/g or <200 mg/g). Greater baseline risk in those with a UACR of 200 mg/g or greater may translate to larger absolute benefits on kidney disease progression.These data support removal of participant stratification by level of albuminuria from the guideline recommendations for use of SGLT2 inhibitors in chronic kidney disease and support more widespread use.

Corresponding Author: William G. Herrington, MD, Nuffield Department of Population Health, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, England (will.herrington@ndph.ox.ac.uk).

Link to the article in your story

We encourage you to link out to this article in your story using the link below. It includes an access token that will give free access to the article for your readers up to one year after publication. (The link will be live after the article publishes and embargo is lifted.)

Please see the article for additional information, including full author list, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

Need more information? Contact us.