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Published on: September 1, 2015
SGLT2 Inhibitors in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis
Ayoub Tantush1, Bahaeddin Ben Hamida2, Malek Sagher3
1General Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Cureus
|May 26, 2026
Summary
Sodium-glucose cotransporter-2 (SGLT2) inhibitors may slow kidney function decline and increase hemoglobin in autosomal dominant polycystic kidney disease (ADPKD) patients. Further research in dedicated trials is recommended.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited kidney disorder.
- Tolvaptan is the current primary disease-modifying therapy for ADPKD.
- SGLT2 inhibitors show renoprotective effects in chronic kidney disease (CKD), but ADPKD patients were excluded from trials.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on SGLT2 inhibitor use in ADPKD patients.
- To assess the efficacy of SGLT2 inhibitors in attenuating estimated glomerular filtration rate (eGFR) decline and improving hemoglobin levels in ADPKD.
Main Methods:
- Systematic review and meta-analysis registered with PROSPERO (CRD420261324155) and PRISMA guidelines.
- Searched five databases through February 2026 for studies involving ADPKD patients on SGLT2 inhibitors.
- Included eight studies (3,180 patients): one RCT, one target trial emulation, and six retrospective observational studies. Quality assessed using RoB2, NOS, and JBI tools.
Main Results:
- SGLT2 inhibitor use was linked to a significant attenuation of eGFR decline (MD: 1.344 mL/min/1.73 m²/year).
- A significant increase in hemoglobin was observed in both comparative and single-arm analyses.
- Subgroup analyses hinted at greater eGFR benefits in non-diabetic patients, but not statistically significant.
Conclusions:
- SGLT2 inhibitors may slow eGFR decline and improve hemoglobin in ADPKD patients.
- The initial eGFR dip with SGLT2 inhibitors is likely a class effect, not harm.
- Dedicated randomized trials are warranted to confirm these findings, considering the observational nature of most included studies.
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