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September 4, 2026Exploration of CardiologyOpen Access

SGLT2 inhibitors slow eGFR decline and reduce kidney and HF hospitalizations in CKD patients.

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Why the study?

Do SGLT2 inhibitors improve cardiorenal outcomes and what are the implementation barriers in adults with chronic kidney disease?

Population

Adults with chronic kidney disease, with or without diabetes.

Comparison

SGLT2 inhibitors vs Standard therapy, placebo, or other…

Design

Systematic_review

Key result

SGLT2 inhibitors consistently slowed eGFR decline and reduced the risk of kidney and heart failure hospitalization in CKD patients, though substantial implementation gaps remain in primary care.

Authors

SNShamsun NaharSHSharar Naiarin HaqueSHSananda Halder

Discussion

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Overview

Supports SGLT2 inhibitor use in CKD for cardiorenal protection; confirms benefits across studies and highlights implementation gaps in primary care.

Key Points

  • To evaluate renal, cardiovascular, safety, and primary care implementation outcomes of SGLT2 inhibitors in patients with chronic kidney disease, with or without diabetes.
  • Conducted a PRISMA-compliant systematic review searching PubMed, Scopus, and Google Scholar for English-language human studies published between 2016 and 2026.
  • Included 15 primary randomized controlled trials and observational studies assessing SGLT2 inhibitors in chronic kidney disease, followed by qualitative synthesis.
  • SGLT2 inhibitors slowed eGFR decline, reduced albuminuria, and decreased the risk of kidney failure and heart failure hospitalization in patients with and without diabetes.
  • Treatment was generally well tolerated, with genital mycotic infections and volume depletion being the most common adverse events and serious adverse events remaining rare.
  • Real-world data consistently demonstrated significant underprescription and implementation barriers in primary care practice.

Study Design

Type

Systematic Review

Structured PICO

Do SGLT2 inhibitors improve cardiorenal outcomes and what are the implementation barriers in adults with chronic kidney disease?

P
Population
A systematic review of 15 primary studies evaluating the renal, cardiovascular, safety, and primary care implementation outcomes of SGLT2 inhibitors in adults with chronic kidney disease, with or without diabetes.
I
Intervention
SGLT2 inhibitors (including empagliflozin, dapagliflozin, canagliflozin)
C
Comparator
Standard therapy, placebo, or other glucose-lowering agents (depending on the included study)
O
Outcome
Renal outcomes (eGFR decline, kidney failure), cardiovascular outcomes (cardiovascular death, hospitalization for heart failure), safety, and primary care implementation

SGLT2 inhibitors are foundational therapies for CKD that provide consistent cardiorenal benefits, but significant implementation barriers persist in primary care.

Limitations

  • Heterogeneity in study design, patient populations, interventions, and outcome measures precluded quantitative synthesis via meta-analysis.
  • Most implementation studies were conducted in high-income countries with differing healthcare systems.
  • Only English-language studies published between 2016 and 2026 were included.
  • This systematic review was not prospectively registered in PROSPERO or another international registry.
  • Methodological quality assessment using tools such as RoB 2 or ROBINS-I was not performed.

Cite This Study

Nahar et al. (2026) conducted a systematic review in Chronic kidney disease. SGLT2 inhibitors vs. Standard therapy or placebo was evaluated on Renal, cardiovascular, safety, and primary care implementation outcomes. SGLT2 inhibitors consistently slowed eGFR decline and reduced the risk of kidney and heart failure hospitalization in CKD patients, though substantial implementation gaps remain in primary care.

synapsesocial.com/papers/6a9a85fa5d9e33f25c63169fhttps://doi.org/10.37349/ec.2026.1012120
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effect of SGLT2 Inhibitors on CKD Progression and All-Cause Mortality: A Meta-Analysis of Randomized Controlled Trials2025
  2. 2Nephroprotective Mechanisms of SGLT2i: Beyond the Glucose-Lowering Effect2025 · 5 citations
  3. 3Repurposing Diabetes Therapies in CKD: Mechanistic Insights, Clinical Outcomes and Safety of SGLT2i and GLP-1 RAs2025 · 8 citations
  4. 4SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria2025 · 59 citations
  5. 5Patient education and monitoring of sodium-glucose co-transporter 2 inhibitors in diabetes2025