SGLT-2 Inhibitors and Acute Declines in Glomerular Filtration Rates

A small-to-moderate initial drop in GFR was not associated with longer-term adverse cardiovascular or kidney outcomes.

When we begin or intensify hypertension treatment, a patient's estimated glomerular filtration rate (eGFR) occasionally drops substantially; this observation can be worrisome in patients with preexisting chronic kidney disease (CKD). In a recent study of patients with CKD, an eGFR decline of >15% shortly after intensification of antihypertensive therapy was associated with excess risk for progression to end-stage renal disease (NEJM JW Gen Med Nov 1 2023 and Am J Kidney Dis 2023; 82:454).

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors are not prescribed primarily to treat hypertension, but they can lower blood pressure. With their growing popularity, understanding the interplay between their short-term and long-term effects on eGFR is im…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

SGLT-2 Inhibitors and Acute Declines in Glomerular Filtration Rates

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Reviewing Author