SGLT2 Inhibitors in Heart Failure and Chronic Kidney Disease: Expanding Therapeutic Horizons beyond Glycemic Control

Year : 2026 | Volume : 16 | 02 | Page :
    By

    Hamsa Priya M,

  • Bharath B,

  • Darshan G,

  1. Student, Department of Pharmacy, Aditya Bangalore Institute of Pharmacy Education and Research, Bangalore, Karnataka, India
  2. Student, Department of Pharmacy, Aditya Bangalore Institute of Pharmacy Education and Research, Bangalore, Karnataka, India
  3. Student, Department of Pharmacy, Aditya Bangalore Institute of Pharmacy Education and Research, Bangalore, Karnataka, India

Abstract

Heart failure (HF) and chronic kidney disease (CKD) are closely related clinical diseases that significantly increase morbidity and death worldwide. The co-occurrence of both conditions is frequently referred to as the “cardio-renal syndrome,” in which the failure of one organ hastens the decline of the other. The original purpose of sodium–glucose cotransporter-2 (SGLT2) inhibitors was to treat type 2 diabetic mellitus (T2DM) by reducing blood sugar levels. Nevertheless, new data from a number of sizable randomized controlled studies has shown that these medications have important protective effects on the heart and kidneys that are not dependent on glucose control. The growing therapeutic use of SGLT2 inhibitors in the treatment of chronic renal disease and heart failure is highlighted in this study. Evidence from seminal clinical trials, including DAPA-HF, EMPEROR-Reduced, EMPEROR-Preserved, DAPA-CKD, and CREDENCE, is presented to demonstrate their capacity to lower cardiovascular mortality, halt the progression of renal impairment, and reduce hospitalizations for heart failure. A summary is also provided of the possible mechanisms that underlie these advantages, such as natriuresis, decreased intraglomerular pressure, enhanced myocardial energy consumption, and anti-inflammatory actions. Regardless of whether diabetes is present or not, the available data generally supports the use of SGLT2 inhibitors as cornerstone treatments for patients with heart failure and chronic renal disease.

Keywords: SGLT2 inhibitors, Heart failure, Chronic kidney disease, Cardio-renal protection, Dapagliflozin

How to cite this article:
Hamsa Priya M, Bharath B, Darshan G. SGLT2 Inhibitors in Heart Failure and Chronic Kidney Disease: Expanding Therapeutic Horizons beyond Glycemic Control. Research and Reviews: A Journal of Pharmacology. 2026; 16(02):-.
How to cite this URL:
Hamsa Priya M, Bharath B, Darshan G. SGLT2 Inhibitors in Heart Failure and Chronic Kidney Disease: Expanding Therapeutic Horizons beyond Glycemic Control. Research and Reviews: A Journal of Pharmacology. 2026; 16(02):-. Available from: https://journals.stmjournals.com/rrjop/article=2026/view=241063


References

1. McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019.
2. Packer M, Anker SD, Butler J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020.
3. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with preserved ejection fraction. N Engl J Med. 2021.
4. Heerspink HJL, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in chronic kidney disease. N Engl J Med. 2020.
5. Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin’s and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019.
6. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015
7. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin’s and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017.
8. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019.
9. Vaduganathan M, Butler J, Sattar N, et al. SGLT2 inhibitors in heart failure: current management and future directions. Lancet. 2022.
10. Rangaswami J, Bhalla V, Blair JEA, et al. Cardiorenal syndrome: classification, pathophysiology, and treatment strategies. Circulation. 2019.
11. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation. 2022.
12. KDIGO Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int. 2022.
13. Butler J, Zannad F, Filippatos G. Efficacy and safety of SGLT2 inhibitors in HF across the spectrum of ejection fraction. Eur Heart J. 2022.
14. Fitchett D, Zinman B, Wanner C. Heart failure outcomes with SGLT2 inhibitors. Circulation. 2019.
15. Packer M. Critical reanalysis of the mechanisms underlying SGLT2 inhibitor benefits. JACC. 2020.

Ahead of Print Subscription Review Article
Volume 16
02
Received 22/03/2026
Accepted 25/04/2026
Published 26/04/2026
Publication Time 35 Days
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