From:  Reframing SGLT2 inhibition as systematic metabolic stress modulation across the cardiovascular-renal-metabolic axis

 Comparison of major randomized trials evaluating renal outcomes and cardiovascular protection with SGLT2 inhibitors.

TrialDrugCKD populationDiabetes statuseGFR inclusionAlbuminuria criteriaPrimary renal endpointKey renal outcomesCardiovascular outcomes
CREDENCECanagliflozinAlbuminuric CKDT2DM only30–90 mL/min/1.73 m²UACR > 300 mg/gESRD, doubling creatinine, or renal death34% reduction in renal composite outcomeReduced HF hospitalization and MACE
DAPA-CKDDapagliflozinCKD with and without diabetesMixed population25–75 mL/min/1.73 m²UACR 200–5,000 mg/g≥ 50% eGFR decline, ESRD, renal or CV death39% relative risk reductionReduced CV mortality and HF hospitalization
EMPA-KIDNEYEmpagliflozinBroad CKD populationMixed population≥ 20 mL/min/1.73 m²Included low and moderate albuminuriaKidney disease progression or CV death28% reduction in disease progressionReduced hospitalization risk
EMPA-REG renal subgroupEmpagliflozinT2DM with CV diseaseT2DM≥ 30 mL/min/1.73 m²Not primary inclusionIncident or worsening nephropathyReduced progression of kidney diseaseReduced CV mortality
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CKD: chronic kidney disease; CV: cardiovascular; T2DM: type 2 diabetes mellitus; eGFR: estimated glomerular filtration rate; UACR: urinary albumin-to-creatinine ratio; ESRD: end-stage renal disease; HF: heart failure; MACE: major adverse cardiovascular events.