A new set of large studies shows that a group of medicines called SGLT2 inhibitors can help protect the kidneys, lower hospitalizations, and reduce the risk of death—even for people without diabetes or with severe kidney problems.
These results come from research presented at the American Society of Nephrology Kidney Week and published in the journal JAMA.
SGLT2 inhibitors were first made to treat type 2 diabetes. But scientists later discovered that they also help people with heart failure and kidney disease.
Until now, there were still questions about how well they work for people with very advanced kidney disease or those who don’t have much protein in their urine (an early sign of kidney damage). It was also unclear if people without diabetes could benefit as much as those with diabetes.
The research looked at data from more than 70,000 people who took part in 10 major clinical trials. These studies were reviewed and combined by a group of scientists called the SMART-C Consortium, led by The George Institute for Global Health.
The first big finding was that SGLT2 inhibitors reduced the risk of worsening kidney disease by 38% compared to a placebo. This benefit was seen in people no matter how well or poorly their kidneys were working, and whether or not they had protein in their urine.
Another important result showed that these medicines slowed the loss of kidney function by 51% each year, again helping people across different stages of kidney disease—even those with stage 4 kidney disease and people with almost no protein in their urine.
The second part of the research looked at how the medicines worked in people with and without diabetes. It found that SGLT2 inhibitors helped both groups.
They were especially good at preventing hospital stays, including for heart failure. The risk of going to the hospital for heart failure dropped by about one-third for people with diabetes and by about one-quarter for people without diabetes.
The studies also showed that serious side effects were rare and that the benefits of taking these medicines were much greater than the risks.
Associate Professor Brendon Neuen, a lead researcher from The George Institute, said this is the strongest proof yet that SGLT2 inhibitors should be used more widely. He said these medicines can help reduce kidney failure, prevent early death, and lower hospital visits for people with kidney disease, heart problems, or diabetes.
He added that many more people could benefit from these drugs than are currently getting them. He believes treatment guidelines should be made simpler to help more doctors and patients use them.
Chronic kidney disease (CKD) affects around 850 million people worldwide. It is a major cause of illness and death. The biggest impact is seen in low- and middle-income countries, where not enough people can access these medicines.
As SGLT2 inhibitors become cheaper and more widely available in generic form, the researchers believe we have a major chance to change the way kidney disease is treated across the world. The findings may help millions of people live longer and healthier lives.
SMART-C is led by Associate Professor Brendon Neuen and Professor Hiddo Heerspink of The George Institute for Global Health.
If you care about kidney health, please read studies about drug that prevents kidney failure in diabetes, and drinking coffee could help reduce risk of kidney injury.
For more information about kidney health, please see recent studies about foods that may prevent recurrence of kidney stones, and common painkillers may harm heart, kidneys and more.
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