Overview
- SGLT2 inhibitors cut the risk of chronic kidney disease progression by 38% and slow annual eGFR decline by 51% versus placebo in pooled results from more than 70,000 participants across 10 randomized trials.
- Benefits were consistent in people with and without diabetes, including those with stage 4 CKD and patients with minimal or no albuminuria.
- Heart-failure hospitalizations fell by nearly one-third in participants with diabetes and by about one-quarter in those without, with serious adverse events reported as uncommon.
- The findings were presented at ASN Kidney Week 2025 and published in companion JAMA papers led by the SMART-C consortium (doi:10.1001/jama.2025.20834; 10.1001/jama.2025.20835).
- Separately, a rat study reported at the meeting found dual SGLT1/2 inhibition with sotagliflozin reduced salt-sensitive hypertension and kidney injury more than SGLT2-only therapy, a preclinical signal that requires clinical testing.