Use of SGLT-2 Inhibitors in Patients with Chronic Kidney Disease

KEY TAKEAWAYS• Chronic kidney disease (CKD) is common, occurring in 1 of 7 adults in the United States.• 9 out of 10 adults with CKD are unaware of it.• People with CKD have the same risk for cardiovascular (CV) death as people with known atherosclerotic heart disease.• The risk for CV events and death increases with worsening albuminuria and estimated glomerular filtration rate (eGFR).• Patients with risk factors for CKD (hypertension, diabetes, family history of CKD, or advancing age) should be screened by measuring both eGFR and urinary albuminto-creatinine ratio.• Sodium-glucose cotransporter-2 inhibitors are first-line agents for treatment of patients with type 2 diabetes mellitus and CKD or a history of atherosclerotic CV disease.• Dapagliflozin has demonstrated equivalent efficacy for reducing kidney events in patients with CKD irrespective of diabetes status, and a similar, ongoing trial with empaglifloz