
This systematic review analyzed observational studies to investigate the kidney benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors in adults with type 2 diabetes (T2D). A total of 34 studies from 15 countries involving 1,494,373 participants were included. The meta-analysis of 20 studies revealed that SGLT2 inhibitors were associated with a 46% lower risk of kidney failure events compared to other glucose-lowering drugs. This benefit was consistent across sensitivity analyses and independent of baseline estimated glomerular filtration rate (eGFR) or albuminuria status. SGLT2 inhibitors also showed a lower risk of kidney failure compared to dipeptidyl peptidase-4 inhibitors and a combination of other glucose-lowering drug classes. However, there was no significant difference in the risk of kidney failure compared to glucagon-like peptide 1 receptor agonists. These findings suggest that SGLT2 inhibitors can protect kidney health in a diverse population of adults with T2D, including those with lower kidney risk. Early use of SGLT2 inhibitors is supported for kidney preservation in T2D.
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