Title: Emerging Role of SGLT2 Inhibitors in Slowing Chronic Kidney Disease Progression: A Mini-Review

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Title: Emerging Role of SGLT2 Inhibitors in Slowing Chronic Kidney Disease Progression: A Mini-Review

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Co-author 1

Mohamed Saafan mohamedsaafan@std.mans.edu.eg Mansoura University Faculty of Medicine Mansoura Egypt *

Co-author 2

Nada Saafan nadasamy@std.mans.edu.eg Mansoura University Faculty of Medicine Mansoura Egypt -

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Introduction

Chronic kidney disease (CKD) remains a major global health challenge with limited therapeutic options to delay progression. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, initially developed for type 2 diabetes, have demonstrated robust renal and cardiovascular protective effects. Synthesizing the latest clinical evidence is crucial to highlight their evolving role as foundational therapy in CKD.

Methods

Methods:

A targeted literature review was conducted using PubMed and Scopus databases to identify pivotal randomized controlled trials and meta-analyses published between 2019 and 2025. Landmark trials (DAPA-CKD, EMPA-KIDNEY, EMPEROR-Preserved) were prioritized. Outcomes of interest included annual eGFR decline, progression to end-stage kidney disease (ESKD), and cardiorenal events.

Results

Results:

SGLT2 inhibitors consistently slowed the rate of eGFR decline by ~1–2 mL/min/1.73m² per year. In major trials, they reduced the composite risk of sustained eGFR decline, ESKD, or renal death by approximately 30–40%. Benefits were evident across diabetic and non-diabetic CKD populations and extended to diverse etiologies, including IgA nephropathy. Cardiovascular advantages included reduced heart failure hospitalizations and cardiovascular mortality. The safety profile was favorable, with increased rates of genital mycotic infections but no significant rise in acute kidney injury or fractures.

Conclusion

Conclusion:

SGLT2 inhibitors represent a paradigm shift in CKD management, offering broad renoprotective and cardioprotective benefits independent of diabetes status. Their early initiation, aligned with KDIGO 2024 guidelines, is critical to altering CKD progression and improving long-term patient outcomes.

Kewords