SGLT2 inhibitor lowers risk of kidney failure in type 2 diabetes

Results showed that canagliflozin improved outcomes in type 2 diabetes patients with kidney disease, preventing kidney failure, heart failure and cardiovascular events

Kidney ultrasound

Patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) have a lower risk of kidney failure and cardiovascular events if they are treated with canagliflozin, research has confirmed[1]

To investigate, researchers in Sydney, Australia, randomly assigned 4,401 patients with T2DM and CKD to either 100mg of canagliflozin — a sodium-glucose co-transporter 2 (SGLT2) inhibitor — or placebo.

All participants were already being treated with renin-angiotensin system blockade and were followed up for a median of 2.6 years.

Results showed that people taking canagliflozin were 30% less likely than those taking placebo to experience the primary outcome, a composite of end-stage kidney disease; a doubling of the serum creatinine level, which can highlight worsening kidney function; or death from kidney or cardiovascular causes.

Event rates were 43.2 per 1,000 patient years in the canaglifozin group and 61.2 per 1,000 patient-years in the placebo group (hazard ratio [HR] 0.70; 95% confidence interval [CI] 0.59–0.82; P=0.00001).

When kidney-specific outcomes were evaluated, the risk was lowered by 34% (HR 0.66; 95% CI 0.53–0.81; P<0.001).

Vlado Perkovic, lead author and professor of medicine at the George Institute for Global Health in Sydney, Australia, said: “[The] trial provides convincing evidence that canagliflozin improves outcomes in diabetes with kidney disease, preventing kidney failure, heart failure and cardiovascular events.” 


[1] Perkovic V, Jardine M, Neal B et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. New Eng J Med 2019;380:2295–2306. doi: 10.1056/NEJMoa1811744

Last updated
The Pharmaceutical Journal, PJ, August 2019, Vol 303, No 7928;303(7928):DOI:10.1211/PJ.2019.20206795

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