Kidney Week

Abstract: SA-PO0522

SGLT2 Inhibitors Reduce CKD Progression: A Meta-Analysis of Major Randomized Controlled Trials

Session Information

• CKD: Clinical - Therapies, CKM Health, Special Populations, and More
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Kaihan, Ahmad Naseer, Balkh University Faculty of Medicine, Mazar-i-Sharif, Balkh, Afghanistan

Ahmad Naseer Kaihan, MD

• Faizi, Hashmat Ullah, Nangarhar University Faculty of Medicine, Jalalabad, Nangarhar, Afghanistan

Hashmat Ullah Faizi, MD

• Farhikhta, Farid, Balkh University Faculty of Medicine, Mazar-i-Sharif, Balkh, Afghanistan

Farid Farhikhta, DrMed, DM

• Kaihan, Ahmad Baseer, Oregon Health & Science University, Portland, Oregon, United States

Ahmad Baseer Kaihan, MD, PhD

Background

Chronic kidney disease (CKD) affects over 10% of the global population and is associated with substantial morbidity and mortality. Conventional therapies slow progression but do not prevent kidney failure. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated renoprotective effects in several randomized trials, but variability in populations and outcomes warrants pooled evaluation.

Methods

We conducted a systematic review and meta-analysis of randomized, placebo-controlled trials evaluating SGLT2 inhibitors in CKD. PubMed was searched for trials reporting composite kidney outcomes, including sustained eGFR decline, end-stage kidney disease (ESKD), or renal death. Eligible studies included CREDENCE, DAPA-CKD, and EMPA-KIDNEY. Hazard ratios (HRs) were pooled using inverse-variance weighting of log-transformed HRs.Statistical analyses were performed using Review Manager (RevMan) version 5.4. Heterogeneity was assessed using the I² statistic.

Results

Three major randomized trials comprising 15,314 participants were included. Study populations represented a broad spectrum of CKD severity and included patients both with and without diabetes mellitus. Individual trial HRs for kidney disease progression were 0.70 (95% CI 0.59–0.82) for CREDENCE, 0.61 (95% CI 0.51–0.72) for DAPA-CKD, and 0.72 (95% CI 0.64–0.82) for EMPA-KIDNEY. Pooled analysis demonstrated a significant reduction in kidney disease progression with SGLT2 inhibitor therapy compared with placebo (pooled HR 0.68, 95% CI 0.62–0.75), corresponding to a 32% relative risk reduction. Heterogeneity was low (I²=17.5%).

Conclusion

SGLT2 inhibitors significantly reduce CKD progression and provide consistent kidney protection across major randomized trials involving diverse patient populations. These findings support the use of SGLT2 inhibitors as foundational therapy in the management of CKD.