SGLT2 inhibitors consistently reduced major adverse outcomes across all chronic kidney disease subgroups. Published in the Journal of the American Medical Association, this meta-analysis pooled 58,816 participants from eight randomized clinical trials with label indications for kidney disease. The mean age was 64 years; 35% were female, and 48,946 had diabetes. Participants were stratified by diabetes status and UACR, and data were analyzed using inverse variance-weighted methods.

Kidney disease progression decreased to 33 vs 48 events per 1,000 patient-years in participants with diabetes (hazard ratio [HR], 0.65) and to 32 vs 46 per 1,000 patient-years in participants without diabetes (HR, 0.74). Rates of acute kidney injury, hospitalization, and all-cause death were also lower in both groups. Hazard ratios were similar across UACR levels. Higher baseline risk in participants with UACR ≥200 mg/g resulted in greater absolute benefit for kidney disease progression, while clinically significant benefits for hospitalization and other outcomes were also observed in those below this threshold.

Overall, SGLT2 inhibitors provided clear renal and survival benefits across all groups studied, supporting broad therapeutic applicability irrespective of diabetes status or albuminuria level.