Sodium-Glucose Cotransporter 2 Inhibitors and Kidney Outcomes across the Spectrum of Kidney Disease: A Systematic Review and Meta-Analysis.
A meta-analysis of 10 large placebo-controlled trials confirms that SGLT2 inhibitors consistently reduce the risk of kidney disease progression across all KDIGO risk categories, including patients previously considered lower-risk.
Study design
This systematic review and meta-analysis included 10 large (≥500 subjects/arm), placebo-controlled randomized trials of SGLT2 inhibitors with at least one year of follow-up, totaling 78,184 participants over a median 2.7 years, stratified by KDIGO risk category and urine albumin-to-creatinine ratio (UACR).
Key findings
SGLT2 inhibitors reduced the composite kidney outcome across all KDIGO categories (hazard ratios ranging 0.48-0.59) and UACR strata (hazard ratios ranging 0.61-0.80), with no evidence of heterogeneity between risk groups.
Clinical implications
The consistent benefit across the full risk spectrum, including lower-risk patients, supports broader consideration of SGLT2 inhibitor therapy for kidney protection rather than reserving it only for high-risk CKD populations.
Category
Research
Source
Clinical Journal of the American Society of Nephrology (CJASN)
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