The study is published in JAMA (The Journal of the American Medical Association) and was presented today at the American Society of Nephrology Kidney Week 2025 in Houston, Texas.
CKD affects an estimated 850 million people worldwide. Many of those at early stages of the disease, especially those without diabetes, remain untreated with SGLT2 inhibitors despite their proven benefits. Prior to this study, there has been uncertainty about the effects of SGLT2 inhibitors in certain types of patients with CKD, with international guidelines recommending different treatments based on diabetes status and urine albumin:creatinine ratio (uACR) of ≥200 mg/g or <200 mg/g.
The researchers combined data from more than 58,816 participants enrolled in eight large randomised trials of SGLT2 inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, versus placebo. The study was conducted by the SGLT2 Inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium (SMART-C).
Key findings:
- SGLT2 inhibitors substantially reduced the risks of kidney disease progression, acute kidney injury, hospitalisation, and death in people with and without diabetes, and across all levels of albuminuria (a measure of kidney damage);
- Compared to placebo, allocation to SGLT2 inhibition reduced the hazard of kidney disease progression by 35% among participants with diabetes and 26% among participants without diabetes;
- Allocation to SGLT2 inhibition reduced the risk of acute kidney injury to a similar extent in participants with and without diabetes by 23% and 28% respectively.
Read the full story on the Nuffield Department of Population Health website.