CLINICAL QUESTION

Are sodium-glucose cotransporter-2 (SGLT-2) inhibitors effective in reducing complications for people with chronic kidney disease (CKD) and type 2 diabetes?

EVIDENCE-BASED ANSWER

SGLT-2 inhibitors reduce the mortality risk in people with any stage CKD and type 2 diabetes (number needed to treat [NNT] to prevent one death in 1 year = 119).¹ (Strength of Recommendation [SOR]: B, inconsistent or limited-quality patient-oriented evidence.) Although it is unclear whether SGLT-2 inhibitors reduce major adverse cardiac events, they reduce the risk of kidney failure (NNT to prevent one case of kidney failure = 35) and kidney composite outcomes (NNT to prevent one negative outcome = 32). (SOR: B, inconsistent or limited-quality patient-oriented evidence.) SGLT-2 inhibitors also may decrease doubling of serum creatinine and albuminuria progression. (SOR: C, consensus, disease-oriented evidence, usual practice, expert opinion, or case series.) SGLT-2 inhibitors may be effective in reducing the risk of some other complications for patients with CKD and type 2 diabetes; however, more studies are needed to better inform treatment decisions.