Sodium-glucose co-transporter-2 (SGLT2) inhibitors demonstrated sustained renal protection in patients with heart failure. The findings of this study were presented at ESC 2025.

The analysis included 13 randomized controlled trials encompassing 90,412 patients across all heart failure phenotypes. During the early phase of treatment, SGLT2 inhibitors induced a modest acute decline in estimated glomerular filtration rate (eGFR). Over the long term, however, eGFR declined more slowly compared to placebo, with chronic slope analyses showing a reduction of 1.37 ml/min/1.73m² per year.

A combined assessment of total and chronic slopes in over 34,000 participants confirmed that SGLT2 inhibitors attenuated kidney function decline by 1.18 ml/min/1.73m² per year. Patients with preserved and mid-range ejection fractions also experienced renal benefits. Those with reduced ejection fraction gained the greatest advantage.

These results highlight the renal-protective effects of SGLT2 inhibitors in heart failure, reinforcing their role beyond cardiovascular outcomes.