Real-world effectiveness of SGLT2 inhibitors on renal and metabolic parameters in patients with chronic kidney disease

Introduction: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have become known as cornerstone therapies, demonstrating glycemic and cardiorenal benefits. While their role on glycemic control is established, real-world data on their impact on renal function (serum creatinine, serum urea, estimated glomerular filtration rate–eGFR) in different stages of chronic kidney disease (CKD) remains limited. This study evaluates the changes in kidney function following SGLT2 inhibitors in adults with varying stages of CKD, including both diabetic and non-diabetic patients.

Methods: This retrospective observational study included CKD patients aged 35 years and older. Patients on dialysis and patients who had side effects (UTI, diarrhea) or intolerance (shortness of breath and palpitations) to therapy were excluded. Kidney function was the primary endpoint, and secondary were glycemic control and electrolytes (natrum and potassium). Measurements were recorded at baseline, one month, and three to six months after the treatment initiation.

Results: Participants (38-80 years), consist of both males and females, predominantly CKD stages 3b-4. After six months of SGLT2 inhibitor therapy, eGFR responses varied. Some patients showed stabilization or improvement, and others experienced initial decline followed by stabilization or a sustained decline. SCr changes paralleled eGFR changes. Reduction in proteinuria wass observed. Patients with diabetes mellitus marked significant improvements in both glucose and HgA1C, while electrolytes remained stable. Metabolic and renal parameters were similar between diabetic and non-diabetic patients.

Conclusions: This real-world retrospective study shows that SGLT2 inhibitors may promote renal stabilization, with metabolic benefits in patients with chronic kidney disease. While individual renal varied, the overall data supports the metabolic and renal benefits of these agents.