SGLT2 inhibitors Use in Kidney Disease: What Did We Learn?

Authors

Munaza M. Akunjee, Division of Endocrinology, Department of Medicine, Veterans Affairs Medical Center, Washington DC, 20422, USA.
Shikha G. Khosla, Division of Endocrinology, Department of Medicine, Veterans Affairs Medical Center, Washington DC, 20422, USA.
Eric S. Nylen, Division of Endocrinology, Department of Medicine, Veterans Affairs Medical Center, Washington DC, 20422, USA.
Sabyasachi Sen, Division of Endocrinology, Department of Medicine, Veterans Affairs Medical Center, Washington DC, 20422, USA.

Document Type

Journal Article

Publication Date

4-25-2025

Journal

American journal of physiology. Endocrinology and metabolism

DOI

10.1152/ajpendo.00034.2025

Keywords

diabetic kidney disease; kidney outcomes; non-diabetic kidney disease; sodium-glucose cotransporter-2 inhibitors

Abstract

Chronic kidney disease (CKD) increases the risk for cardiovascular morbidity and mortality and it's prevalence continues to rise throughout the world. Newer, more efficacious therapies, slow progression of CKD, decrease long term sequala like end stage kidney disease (ESKD) and cardiovascular events, improving survival. Post marketing cardiovascular outcome trials (CVOT) have demonstrated improved cardiovascular outcomes with use of sodium-glucose cotransporter-2 inhibitors SGLT2i) like canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin in patients with type 2 diabetes mellitus (T2DM), Similarly, secondary analysis of CVOT and renal outcome trials with the use of SGLT2i in patients without T2DM showed improved renal function and albuminuria. In these studies, non-diabetic CKD was defined as an estimated glomerular filtration rate (eGFR) of 20-75 ml/min/1.73 m2 with albuminuria ranging from 200-5000 mg/g in the absence of diabetes. As a class effect, in addition to modulation of hemodynamic and metabolic activities, SGLT2i exert renal protection by suppressing inflammation and fibrosis. We conducted an extensive search in the PubMed database for original papers published from 2009 through 2024 using keywords such as non-diabetic kidney disease, diabetic kidney disease, SGLT2i, and kidney outcomes. Based on our research of published literature, we present a review and propose, consideration of SGLT2i in non-diabetic kidney disease for long term cardiovascular and renal benefit (1). We will highlight relevant translational studies to propose a possible cell-based mechanism for cardiovascular benefits noted secondary to use of SGLT2i.

APA Citation

Akunjee, Munaza M.; Khosla, Shikha G.; Nylen, Eric S.; and Sen, Sabyasachi, "SGLT2 inhibitors Use in Kidney Disease: What Did We Learn?" (2025). GW Authored Works. Paper 6987.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6987

Department

Medicine