SAT-630 Long-Term Renal Outcomes of Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Abstract

Abstract Disclosure: C.A. Pascoal: None. L.A. Bendaham: None. L.S. Bahia: None. S. Braga Lisboa: None. A. Francisco: None. E.A. Correia: None. M.A. Gonçalves: None. C.V. de Oliveira: None. B.B. Masiero: None. Background: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are drugs recently added to the therapeutic arsenal for type 2 diabetic mellitus (T2DM) patients. However, doubts regarding the long-term renal effects of this medication remain unknown. This meta-analysis evaluates the long-term renal outcomes of SGLT2i in T2DM. Methods: We systematically searched Pubmed, Embase, and Cochrane Central for randomised controlled trials (RCTs) with ≥ 104 weeks of follow-up. We included studies comparing SGLT2i with placebo or any hypoglycemic agent in patients with T2DM. Outcomes were estimated glomerular filtration rate (eGTF), acute renal failure or injury, renal impairment and urine albumin-creatinine ratio (uACR). Risk ratios (RR) and Mean Difference (MD) with 95% confidence intervals (CI) were computed using a random-effects model. Results: We included 10 RCTs assessing the effects of SGLT2i on renal outcomes. SGLT2 inhibitors significantly reduced the risk of acute renal failure or injury (RR 0.77; 95% CI 0.65 to 0.91; Figure A). They also significantly reduced the uACR, with a mean difference of -9.56 (95% CI -15.11 to -4.00). However, no significant differences were observed for the eGFR (MD 0.83; 95% CI -1.42 to 3.09; Figure B) or for the risk of renal impairment (RR 1.32; 95% CI 0.74 to 2.34). Conclusions: SGLT2i reduced risk of acute renal failure or injury and uACR in patients with T2DM over the long-term follow-up compared with placebo or any hypoglycemic drug. No differences between groups are shown in eGTF and in renal impairment. Presentation: Saturday, July 12, 2025