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Meta-analysis of dapagliflozin for renal outcomes in type 2 diabetes and CKDSGLT2 inhibitors lower kidney failure risk in type 2 diabetes patients

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider dapagliflozin's mixed renal effects in type 2 diabetes and CKD based on meta-analysis findings.

This is a systematic review and meta-analysis of 10 studies from domestic and foreign databases, examining renal outcomes with 5 mg dapagliflozin versus a control group in patients with type 2 diabetes mellitus and chronic kidney disease. The authors synthesized evidence on primary outcomes including eGFR, CrCI, renal-related adverse events, doubling of serum creatinine, end-stage renal disease, renal death, and acute kidney injury or failure.

The meta-analysis found that dapagliflozin was associated with a more significant decline in eGFR and CrCI levels. For renal-related adverse events, the risk was reduced with an OR of 0.91 (95% CI: 0.84 to 0.99, P = 0.04). The risk for doubling of serum creatinine, end-stage renal disease, and renal death events was also reduced, with an OR of 0.68 (95% CI: 0.60 to 0.78, P < 0.00001). No statistically significant difference was found for acute kidney injury or failure.

The authors note that SGLT2 inhibitors can cause a short-term decline in eGFR and CrCl, while significantly reducing the risk of renal composite endpoint events. Sensitivity analysis suggested the results were stable and reliable. Limitations of the evidence base were not detailed in the provided data.

Practice relevance is framed as providing an evidence-based basis for clinical rational treatment. The synthesis does not report follow-up duration, absolute numbers, or specific study populations beyond the general patient group described.

People with type 2 diabetes often worry about their kidneys failing. A new analysis looked at ten studies to see if a specific drug class called SGLT2 inhibitors helps protect them. These medicines work by helping the body remove sugar through urine. The research focused on patients who already had both diabetes and chronic kidney disease.

The results were clear. While the drugs caused a more noticeable drop in kidney function numbers early on, this was a known effect. More importantly, the risk of serious kidney problems went down significantly. Patients taking the medicine had a lower chance of needing dialysis or facing kidney death compared to those who did not take it.

The analysis also checked for safety. The risk of other kidney-related side effects was slightly lower for those on the medication. However, the study did not report on how many people stopped taking the drug or how well they tolerated it overall. Despite these gaps, the findings suggest these drugs offer a solid basis for better treatment choices.

What this means for you:
SGLT2 inhibitors lower the risk of serious kidney events in people with type 2 diabetes and kidney disease.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
ObjectiveTo analyze and evaluate the impact of SGLT2 inhibitors on the renal outcomes of patients with type 2 diabetes mellitus and chronic kidney disease, and to provide evidence-based basis for clinical rational treatment.MethodsRelevant literatures on the impact of SGLT2 inhibitors on the renal outcomes of patients with type 2 diabetes mellitus and chronic kidney disease published in domestic and foreign databases were retrieved and collected. The time limit was from the establishment of each database to November 2025. After screening, the quality of the research literature was evaluated using the Cochrane library. Literature management was conducted using NoteExpress 3.2, and data collection and extraction were carried out using Excel 2003. Statistical analysis was performed using RevMan 5.4.1 software. Based on the size of the Q test (P value), it was determined whether there was heterogeneity in the studies, and then the fixed or random effect model was used to calculate the combined effect OR value, and a forest plot was drawn. Then, the publication bias was evaluated by drawing a funnel plot.ResultsA total of 10 studies that met the inclusion criteria were finally included. The meta-analysis results showed that compared with the control group, the eGFR and CrCI levels of patients treated with 5 mg dapagliflozin showed a more significant decline, renal-related adverse events (OR = 0.91, 95% CI: 0.84 to 0.99, P = 0.04), and the occurrence of doubling of serum creatinine, end-stage renal disease, and renal death events (OR = 0.68, 95% CI: 0.60 to 0.78, P < 0.00001). However, there was no statistically significant difference in acute kidney injury or failure between the two groups. Sensitivity analysis suggested that the results of this study were stable and reliable.ConclusionSGLT2 inhibitors can cause a short-term decline in eGFR and CrCl, and significantly reduce the risk of renal composite endpoint events. This indicates that their early hemodynamic effects are predictable physiological changes.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261294499, identifier CRD420261294499.
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