A recent systematic review and meta-analysis has examined the effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on dialysis, transplantation and death due to kidney disease in patients with type 2 diabetes. The reliability of effect size across trials was also assessed with respect to varying levels of estimated glomerular filtration rate (eGFR) and albuminuria. Empagliflozin, canagliflozin and dapagliflozin were the SGLT2 inhibitors used across 38,723 patients included in the study, 252 of which required dialysis, transplantation or died of kidney disease, 335 of which had end-stage kidney disease and 943 of which had acute kidney injury. Across all studies in the analysis, SGLT2 inhibitors were found to reduce the risk of dialysis, transplantation, or death due to kidney disease (RR 0·67, 95% CI 0·52–0·86, p=0·0019), end-stage kidney disease (0·65, 0·53–0·81, p<0·0001), and acute kidney injury (0·75, 0·66–0·85, p<0·0001).  Benefit was observed in all eGFR subgroups and uniform renoprotection was seen across the included studies, regardless of albuminuria and renin-angiotensin system blockade. The study, which can be viewed here, suggests that SGLT2 inhibitors may be effective in preventing major kidney outcomes for patients with type 2 diabetes.

Contributed by Australian Medication Safety Services Associate – Isabella Singh