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This is a Literature Review study.

September 10, 2025

SGLT2 inhibitors and acute kidney injury

YNYuki NakaoTokyo Institute of Technology MMMakiko MoriTokyo Institute of Psychiatry YMYutaro MoriTokyo Medical and Dental University

Puntos clave

SGLT2 inhibitors may reduce risks for acute kidney injury in humans, suggesting protective mechanisms.
Clinical data show that SGLT2 inhibitors, like dapagliflozin, have renal protective effects beyond glucose lowering.
Physiological evidence supports that SGLT2 inhibitors can influence kidney function and health positively.
The mechanisms by which SGLT2 inhibitors protect against acute kidney injury remain an area for further exploration.

Resumen

Abstract Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are glucose-lowering agents that inhibit glucose reabsorption by the proximal tubules of the kidney. Since the introduction of the first SGLT2 inhibitor in 2012, dapagliflozin, canagliflozin and empagliflozin have been developed and been rapidly integrated into clinical medicine, initially to manage type 2 diabetes. Over a short period of time, however, it has become apparent that SGLT2i not only reduces blood glucose but also provides long-term protective effects on the kidneys and heart. In this review, we present physiological data on what is known about SGLT2i effects on the kidney, present the ever-expanding clinical data relating to the effects of SGLT2i on the occurrence of acute kidney injury (AKI) and integrate what is known about molecular mechanisms with clinical experience. We conclude that SGLT2i may reduce the risks for AKI in humans. We speculate on mechanisms by which SGLT2 inhibitors may protect against AKI.

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