Settled
Do SGLT2 inhibitors improve kidney outcomes versus placebo?
Mostly studied in type 2 & unspecified diabetes. Also asked against other treatments.
Not modeled yetTrial evidence exists, but no mechanistic model yetWithout a model there is no decisive experiment to propose. Help build it. →
Where the evidence stands
Very likely. So far, established.
NoUnsureYes
- Belief
- 0.89 (range 0.68–0.99)
- Trials for
- 8
- Trials against
- 1
- Inconclusive
- 3
Already under way
- Individual and Combined Endothelin Receptor and SGLT2 Antagonism in Adults With Type 1 Diabetes Mellitus and Chronic Kidney Disease: a Phase 2, Multicenter,…NCT06072326 · not yet recruiting · started 2026
- Randomized Trial of Sodium-glucose Cotransporter 2 Inhibition in Heart Transplant RecipientsNCT06625073 · recruiting · started 2026
- Role of Finerenone in African American Veterans With Diabetic Kidney DiseaseNCT07155694 · not yet recruiting · started 2026
- Sodium-Glucose Cotransporter-2 Inhibitor for Amelioration of Acute Cardiorenal Syndrome: A Randomized Controlled TrialNCT07273838 · recruiting · started 2026
- Comparative Study on the Mode of Action of Vicadrostat and Spironolactone on Protein Profiles and Renal Hemodynamic Effects in Patients Chronic Kidney Disease…NCT07304817 · recruiting · started 2026
The evidence so far
- Registered trials
- 229
- With posted results
- 41
- Published papers
- 11
Of 43 decided analyses: 19 favor sglt2 inhibitors, 16 find no difference, 8 favor the comparator.
Papers
- Early Change in Albuminuria with Canagliflozin Predicts Kidney and Cardiovascular Outcomes: ATrial report · 2020
- Insights from CREDENCE trial indicate an acute drop in estimated glomerular filtration rate during treatment with canagliflozin with implications for clinical practice.Trial report · 2021
- Elevated serum magnesium associated with SGLT2 inhibitor use in type 2 diabetes patients: a meta-analysis of randomised controlled trials.Meta-analysis / systematic review · 2016
- Sodium-glucose co-transporter-2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta-analysis of randomized controlled trials.Meta-analysis / systematic review · 2017
- Effects of canagliflozin on major adverse cardiovascular events by baseline estimated glomerular filtration rate: Pooled Hispanic subgroup analyses from the CANVAS Program and CREDENCE trial.Meta-analysis / systematic review · 2022
- Dose-dependent renoprotection efficacy of sglt2 inhibitors in type 2 diabetes: systematic review and network meta-analysis.Meta-analysis / systematic review · 2023
Trials
- Comparative Cardiovascular and Renal Effectiveness and Safety of Empagliflozin and Other SGLT2i in Patients With Type 2 Diabetes (T2D) With and Without Baseline Kidney Disease in the United StatesNCT05465317 · 16 posted results
- An Exploratory Phase 2 Study to Assess the Effect of Dapagliflozin on Glomerular Filtration Rate (GFR) in Subjects With Type 2 Diabetes Who Have Inadequate Glycemic and Blood Pressure (BP) ControlNCT00976495 · 2 posted results
- Post-authorisation Safety Study in Patients With Type 2 Diabetes Mellitus to Assess the Risk of Acute Liver Injury, Acute Kidney Injury and Chronic Kidney Disease, Severe Complications of Urinary Tract Infection, Genital Infections, and Diabetic Ketoacidosis Among Patients Treated With Empagliflozin Compared to Patients Treated With DPP-4 InhibitorsNCT02864914 · 6 posted results
- A Randomized, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of JNJ-28431754 on Cardiovascular Outcomes in Adult Subjects With Type 2 Diabetes MellitusNCT01032629 · 12 posted results
- A Randomized, Double-blind, Placebo-controlled Study to Evaluate Efficacy and Safety of Canagliflozin (TA-7284) in Patients With Diabetic NephropathyNCT03436693 · 5 posted results
- An Exploratory Phase II/III, Randomized, Double-blind, Placebo Controlled, Parallel Design Study to Evaluate the Efficacy, Safety and Pharmacodynamics of Dapagliflozin and Dapagliflozin in Combination With Saxagliptin in CKD Patients With Type 2 Diabetes Mellitus and Albuminuria Treated With ACEi or ARBNCT02547935 · 4 posted results
- A Randomized, Double-blind, Event-driven, Placebo-controlled, Multicenter Study of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Subjects With Type 2 Diabetes Mellitus and Diabetic NephropathyNCT02065791 · 13 posted results
- A Randomized, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of Canagliflozin on Renal Endpoints in Adult Subjects With Type 2 Diabetes MellitusNCT01989754 · 1 posted result