SGLT2 Inhibitors Could Play Role in Slowing Kidney Disease Progression

A woman sits at a table with another person reviewing medicines that are on the table in front of them.

For years, kidney care has primarily focused on managing kidney failure. Now, new data is empowering a crucial clinical focus: preserving kidney function before kidney disease advances.

A recent study published in JAMA Internal Medicine provides a compelling signal for care providers: When it comes to slowing chronic kidney disease (CKD) progression for people with Type 2 diabetes, SGLT2 inhibitors may offer a distinct advantage. The findings from Aarhus University in Denmark emphasize the importance of early, targeted intervention in CKD, with a particular look at contributing conditions, like diabetes.

SGLT2 inhibitors, like GLP-1 medications, are designed to treat Type 2 diabetes, but they protect the kidneys using different mechanisms. While GLP-1s mimic a hormone to regulate insulin and appetite, SGLT2 inhibitors work directly in the kidneys to block specific proteins (SGLT2) to help prevent sugar from getting reabsorbed into the blood.

Study Highlights

  • Stronger Kidney Protection: SGLT2 inhibitors were linked to a significantly lower five-year risk of both worsening kidney disease and sudden kidney failure (acute kidney injury) compared to GLP-1s.
  • Preserved Kidney Function: Patients on SGLT2 inhibitors saw better stability in their estimated glomerular filtration rate (eGFR), a measure of kidney function, over time — a critical factor for long-term health.
  • Benefits for “Low-Risk” Patients: These protective effects were strongest in patients who still had good kidney function, reinforcing the value of early care, before the disease advances.
  • Protein Management: While SGLT2 inhibitors excelled at keeping overall kidney function stable, GLP-1s were more effective at controlling albuminuria — protein loss in the urine — suggesting each drug protects the kidneys in a different way. This also suggests the potential benefits of using both therapies together.

Why It Matters

As DaVita continues to help accelerate integrated kidney care, these findings validate the broader strategy of engaging with patients earlier in their kidney health journeys — before they require kidney transplant or dialysis. By identifying patients at risk for kidney disease sooner, clinicians may be able to leverage protective therapies, like SGLT2 inhibitors, to help slow disease progression and protect quality of life.

“Pinpointing the right intervention — or interventions —early on over the course of a patient health journey can help physicians alter the disease trajectory, for example preventing or slowing kidney disease progression in individuals with type 2 diabetes,” says Francesca Tentori, MD, vice president of DaVita outcomes research and patient empowerment. “Studies like this one out of Denmark helps us reinforce what we are seeing in the shift to upstream, holistic care: The earlier we intervene with the right therapies, the more opportunities we have to protect our patients’ futures.” 

While randomized clinical trials are needed to confirm these observational results, the data provides a strong signal for clinicians to consider SGLT2 inhibitors as a frontline defense for kidney preservation in patients with Type 2 diabetes.

You can find more information about this study from Healio | Nephrology News & Issues.