SGLT2 Inhibitors Remain Protective Even After Severe eGFR Decline: Pooled Trial Analysis Across Cardio‑Renal‑Metabolic Populations

Highlights

• In a pooled, time-updated analysis of five randomized, placebo‑controlled trials (n=26,946), 5.2% of participants experienced eGFR deterioration to <25 ml/min/1.73 m2 and 2.3% to <20 ml/min/1.73 m2 during follow-up.

• Severe eGFR deterioration during follow‑up was independently associated with nearly double the risk of subsequent heart‑failure hospitalization or cardiovascular death, major atherothrombotic events, and all‑cause mortality.

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