Effectiveness of SGLT2 inhibitors in slowing chronic kidney disease progression and reducing mortality: a meta-analysis
Abstract
Background: Chronic kidney disease (CKD) represents a significant health problem worldwide with high morbidity, mortality, and development of end-stage kidney disease (ESKD). Sodium-glucose co-transporter 2 (SGLT2) inhibitors represent an innovative class of medications with possible cardiorenal advantages. We conducted a Meta-analysis to assess their efficacy in CKD management.
Methods: Our Meta-analysis was performed using the Preferred Reporting Items for Meta-analyses (PRISMA) guidelines and is registered in PROSPERO (CRD420261362785). Databases used for conducting this systematic review include Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, PubMed Central, and Google Scholar. The databases were searched from their inception till 16 April 2026. Clinical trials in adults diagnosed with CKD were included in this study if they compared the use of SGLT2 inhibitors versus placebo. A random-effects model was used for meta-analysis.
Results: Thirteen randomized controlled trials (RCTs) (n = 49,931) were analyzed. A statistically significant increase in total and chronic estimated glomerular filtration rate (eGFR) slope was seen (mean difference: MD = 0.97 mL/min/1.73 m2/year, 95% CI: 0.34 to 1.59 and MD = 1.92, 95% CI: 1.91-1.93). There was a statistically significant reduction in albuminuria (ratio of means showing 37% reduction, 95% CI: 1.12-1.68). The risk of ESKD was significantly reduced by 30% (RR = 0.70, 95% CI: 0.65-0.75), while the doubling of serum…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 49,931 participants or records.
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