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Sodium-glucose cotransporter 2 inhibitors for chronic kidney disease: Why, when and when not

Muhammad M Javaid1, Rachel Frederick2, Sheema Itrat3

  • 1FRCP, FASN, FRACP, Adjunct Clinical Associate Professor, Rural Health Mildura, Monash University, Melbourne, Vic; Affiliate Associate Professor, School of Medicine, Deakin University, Warrnambool, Vic; Staff Specialist Nephrologist and Physician, South West Healthcare, Warrnambool, Vic.

Australian Journal of General Practice
|December 18, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a safe and effective treatment to slow chronic kidney disease (CKD) progression. These medications benefit patients regardless of diabetes status and are recommended for most CKD patients in primary care.

Area of Science:

  • Nephrology
  • Pharmacology

Background:

  • Chronic kidney disease (CKD) presents a substantial global health challenge, with advanced stages linked to higher mortality, morbidity, and healthcare costs.
  • Early intervention to slow CKD progression is crucial for patient outcomes and economic savings.

Purpose of the Study:

  • To furnish general practitioners with evidence-based guidance on initiating sodium-glucose cotransporter 2 (SGLT2) inhibitors for CKD patients.
  • To support clinical decision-making in primary care settings for CKD management.

Main Methods:

  • Review of randomized controlled trials (RCTs) evaluating SGLT2 inhibitors in CKD patients.
  • Analysis of evidence regarding efficacy in slowing disease progression across different CKD stages and in relation to diabetes status.

Main Results:

  • RCTs demonstrate that SGLT2 inhibitors significantly slow the progression of CKD.
  • The benefits of SGLT2 inhibitors in managing CKD are evident in both early and advanced disease stages.
  • Efficacy of SGLT2 inhibitors is consistent irrespective of a patient's diabetes status.

Conclusions:

  • SGLT2 inhibitors represent a valuable and safe therapeutic option for CKD management, complementing existing renin-angiotensin-aldosterone system blockers.
  • Consideration of SGLT2 inhibitors is recommended for the majority of CKD patients within primary care.
  • These agents offer a promising strategy to improve long-term outcomes in chronic kidney disease.

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