Introduction: Chronic kidney disease (CKD) pertains a sizeable burden on healthcare systems worldwide and is associated with significant morbidity and mortality. Recently, there has been compelling evidence associating SGLT2i usage with improved renal function and delayed progression in underlying CKD. Objective: To assess the efficacy of SGLT2i on the development of CKD in non-diabetic patients, with special attention to their efficacy, side effects, and “hard” renal outcomes such as progression to renal replacement therapy and worsening eGFR. Methodology: A broad search in the available medical databases (e.g MEDLINE, SCOPUS) was undertaken. Results: The available literature points strongly towards an overall nephroprotective effect of SGLT2i, even in non-diabetic patients. This is through reducing the rate of eGFR decline and a reduction in albuminuria (as assessed by the UACR). Furthermore, they were linked to enhanced cardiovascular outcomes, reduced hospitalizations, and overall mortality. However, certain potential risks, such as reduced antihyperglycemic effect in advanced CKD stages, risk of infections, and rare side effects, were identified. Conclusion: SGLT2i will have a prominent role in the management of CKD patients without underlying diabetes, given the currently available data. Their significant renoprotective effects, combined with cardiovascular benefits, offer a potentially enhanced therapeutic approach. While presenting some challenges, the consistent findings across multiple studies support the broader adoption of SGLT2i in CKD management. Further long-term studies might strengthen the current understanding and provide deeper insights into their broader implications in the medical field.
Mostafa Mohrag (Sat,) studied this question.