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Cardio-Vasculo-Renal Benefits of SGLT2 Inhibitors in Heart Failure: A Retrospective Study from a Lower-Resource

Olivia-Maria Bodea1,2, Gabriel Florin Răzvan Mogoș3, Nilima Rajpal Kundnani2,4

  • 1Doctoral School, "Victor Babes" University of Medicine and Pharmacy, 3000041 Timisoara, Romania.

Medicina (Kaunas, Lithuania)
|February 27, 2026
PubMed

Insights

Sodium glucose cotransporter 2 (SGLT2) inhibitors may reduce adverse cardio-renal events in heart failure patients with reduced ejection fraction. Real-world data suggest SGLT2 inhibitors slow kidney function decline and decrease heart failure hospitalizations.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, worsening patient prognosis through cardio-renal interactions.
  • Sodium glucose cotransporter 2 (SGLT2) inhibitors show promise for cardiovascular and renal benefits, but real-world data in lower-resource settings are scarce.

Purpose of the Study:

  • To evaluate the real-world effectiveness of SGLT2 inhibitors in patients with chronic heart failure and reduced ejection fraction (LVEF ≤ 45%).
  • To assess the impact of SGLT2 inhibitors on cardio-vasculo-renal outcomes and kidney function trajectory in this population.

Main Methods:

  • Retrospective single-center cohort study of 240 adult patients with chronic HF and LVEF ≤ 45% (2021-2024).
  • Patients were stratified based on SGLT2 inhibitor use.
  • Primary endpoint: composite of cardiovascular death, HF hospitalization, or ≥40% sustained eGFR decline/KRT initiation. Annual eGFR slope analyzed.

Main Results:

  • SGLT2 inhibitor use was linked to a reduced risk of the composite cardio-vasculo-renal endpoint (adjusted HR 0.70, 95% CI 0.50-0.98).
  • This reduction was mainly driven by fewer heart failure hospitalizations.
  • Longitudinal analyses indicated a slower decline in kidney function among SGLT2 inhibitor-treated patients.

Conclusions:

  • In this observational study, SGLT2 inhibitors were associated with improved cardio-renal outcomes and preserved kidney function in HF patients.
  • Findings are hypothesis-generating due to observational design and potential residual confounding.
  • Results provide implementation-relevant signals supporting further prospective research on SGLT2 inhibitors in HF and CKD.

Keywords:
SGLT2ieGFRglycemic controlkidney functiontreatment algorithms

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