Kidney Week

Abstract: TH-PO0341

Effect of SGLT2 Inhibitors on Blood Pressure in Adult Patients with CKD: Systematic Review and Meta-Analysis

Session Information

• Hypertension and CVD: Clinical - 1
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Puttam, Harivarsha, Shasta Regional Medical Center, Redding, California, United States

Harivarsha Puttam, MD, MBBS

• Kung, Claire, Union College, Schenectady, New York, United States

Claire Kung

• Pabla, Herleen, Government Medical College and Hospital, Chandigarh, India

Herleen Pabla, MBBS

• Deshmukh, Sameer Subhash, University of Alabama at Birmingham Health System Authority, Birmingham, Alabama, United States

Sameer Subhash Deshmukh, MD, MBBS

• Khan, Maham, Fatima Jinnah Medical University, Lahore, Punjab, Pakistan

Maham Khan

• Mehta, Priyal D., Saint Vincent Hospital, Worcester, Massachusetts, United States

Priyal D. Mehta, MBBS

• Kashyap, Rahul, Global Remote Research Scholars Program, Princeton Junction, New Jersey, United States

Rahul Kashyap, MBBS, MBA

• Bansal, Vikas, Global Remote Research Scholars Program, Princeton Junction, New Jersey, United States

Vikas Bansal, MBBS, MPH

Background

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are novel antihyperglycemic agents also approved for managing heart failure and chronic kidney disease (CKD). In CKD patients, blood pressure (BP), and glycemic control are essential to slowing disease progression. While clinical trials have reported BP-lowering effects of SGLT-2 inhibitors, the magnitude of this effect in CKD remains unclear. We conducted a systematic review and meta-analysis to assess the BP-lowering effects of SGLT-2 inhibitors in adult CKD patients.

Methods

We systematically searched PubMed, ClinicalTrials.gov, ScienceDirect, and Cochrane databases for studies published from 2010 to February 10, 2024. The search strategy included MeSH terms and keywords such as “SGLT-2 inhibitors,” “canagliflozin,” “empagliflozin,” “dapagliflozin,” “CKD,” “hypertension,” and “blood pressure.” We included placebo-controlled randomized controlled trials (RCTs). Rayyan™ was used for screening and data extraction. Data from 7 RCTs were analyzed using RevMan 5.4 to generate forest plots and assess heterogeneity. Sensitivity and subgroup analyses were performed. The study followed PRISMA guidelines, was IRB-exempt, and registered with PROSPERO (CRD42024524960). Primary outcomes were changes in systolic and diastolic BP (SBP, DBP). Secondary outcomes included changes in body weight, HbA1c, and fasting plasma glucose (FPG).

Results

Seven RCTs (n=6,367) were included. SGLT2 inhibitors significantly reduced SBP by 3.12mmHg (95% CI: –3.63 to –2.60; p<0.00001, I²=0%) and DBP by 2.25 mmHg (95% CI: –3.19 to –1.32; p<0.00001, I²=0%). Secondary analyses showed significant reductions in body weight (–1.46 kg; 95% CI: –1.73 to –1.18; p<0.00001), HbA1c (–0.32%; 95% CI: –0.44 to –0.21; p<0.00001), and FPG (–0.84 mmol/L; 95% CI: –1.10 to –0.58; p<0.00001). Subgroup analyses showed consistent effects across CKD stages 2 and 3, with limited data in advanced CKD.

Conclusion

SGLT2 inhibitors effectively reduce BP, body weight, HbA1c, and FPG in CKD patients. Further research is needed to assess their long-term impact, and also on dialysis-dependent patients.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025qea40xgm