Two major new studies have revealed that a widely used class of diabetes medications—known as SGLT2 inhibitors—can strongly protect the kidneys, prevent hospitalizations, and even reduce the risk of death in people both with and without diabetes.
These findings come from data involving more than 70,000 participants and show benefits across almost every group studied, regardless of a person’s level of kidney function.
The results were presented at the American Society of Nephrology Kidney Week meeting and published in two companion papers in JAMA.
They were based on a massive combined analysis of ten large randomized controlled trials conducted by the SGLT2 Inhibitor Meta-analysis Cardio-Renal Trialists’ Consortium (SMART-C), led by The George Institute for Global Health.
SGLT2 inhibitors were originally created to lower blood sugar in people with type 2 diabetes. But over the past decade, researchers noticed something remarkable: people taking these medications also had far fewer cases of heart failure, kidney decline, and serious complications related to chronic kidney disease (CKD).
These new studies confirm just how powerful the medicines are—and that their benefits extend to almost everyone, even those without diabetes.
In the first analysis, researchers found that SGLT2 inhibitors reduced the risk of CKD progression by 38 percent compared with placebo. This protection was consistent across all levels of kidney function, including people with very advanced CKD.
The drugs also slowed the yearly decline in kidney function by 51 percent, meaning they helped kidneys stay healthier for longer. Notably, the benefits were seen even in people with stage 4 CKD and those who had very little or no protein in their urine—groups that previously did not have clear treatment recommendations.
The second analysis looked at whether the benefits differ between people with or without diabetes. The results showed strong benefits for both groups. Hospitalizations related to heart failure dropped by nearly one-third in people with diabetes and by about one-quarter in those without diabetes.
These improvements came with very few serious side effects. For most patients, the health gains far outweighed the risks.
Associate Professor Brendon Neuen, one of the lead researchers, said these studies provide the strongest evidence so far that SGLT2 inhibitors should be used widely in people with chronic kidney disease.
He explained that these medicines could greatly reduce the burden of kidney failure, hospitalizations, and early death for millions of people. Dr. Neuen also said the findings support simplifying treatment guidelines so that more people can benefit.
Chronic kidney disease is a growing global health challenge. It affects around one in ten people worldwide—more than 850 million individuals. Many patients, especially in low- and middle-income countries, struggle to access effective treatments.
Because SGLT2 inhibitors will soon become more affordable as generic versions enter the market, researchers believe there is a unique chance to transform kidney care across the world.
In reviewing the study results, the evidence is clear and compelling. First, the consistency of benefit across every major group—including those with late-stage CKD and those without diabetes—shows that these drugs have broader value than previously understood.
Second, the strong reductions in hospitalization and death rates point to meaningful real-world improvements that go far beyond lab results. Third, the very low rate of serious side effects strengthens confidence that SGLT2 inhibitors can be used safely for long-term treatment.
Finally, the size and scope of the data, covering more than 70,000 participants, make these conclusions more reliable than any previous study on the topic.
This research marks an important moment in kidney and heart health. For millions of people facing chronic kidney disease, SGLT2 inhibitors may offer a longer, healthier life—and a powerful new tool to slow or prevent kidney failure before it occurs.
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The study is published in JAMA.
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