Overview
- Two SMART-C meta-analyses spanning more than 70,000 participants across 10 randomized trials found a 38% lower risk of CKD progression versus placebo and a 51% slower annual eGFR decline.
- Benefits were consistent in people with and without diabetes, extended to those with minimal or no albuminuria, and included patients with stage 4 CKD.
- SGLT2 inhibitors reduced hospitalizations, including for heart failure, and the low rate of serious adverse events was outweighed by gains in health and survival.
- Investigators urged simpler, broader treatment guidelines to expand global access as prices fall, citing the opportunity to reduce kidney failure and premature death at scale.
- A preclinical rat study reported that dual SGLT1/2 inhibition with sotagliflozin outperformed dapagliflozin for salt-sensitive hypertension and kidney injury, a hypothesis-generating signal that requires clinical confirmation.