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New research uncovers the potential benefits and risks of sodium-glucose cotransporter 2 (SGLT2) inhibitors for adults aged 80 years or older with chronic kidney disease (CKD). The findings will be presented at ASN Kidney Week 2026, Oct. 22–25.
In their analysis of electronic health records data on 10,076 adults aged 80 years or older with CKD, investigators found that over a two-year follow-up, initiating SGLT2 inhibitor therapy was linked to an 18% reduction in all-cause mortality and a 22% reduction in major adverse kidney events. There was no significant effect on major adverse cardiovascular events overall, but SGLT2 inhibitors were associated with higher risks of specific cardiac events like heart attacks and acute heart failure, as well as acute kidney injury.
"Very elderly individuals are historically underrepresented in or systematically excluded from large-scale randomized controlled trials due to multimorbidity and frailty. By leveraging real-world data, our research addresses a crucial blind spot in current medical literature," said corresponding author Bernhard M. W. Schmidt, M.D., S.M., from the Department of Nephrology and Hypertension at Hannover Medical School in Germany.
"Even the oldest and most vulnerable CKD patients can derive substantial benefits from SGLT2 inhibitor treatment, but these medications may not be without risk in this demographic. These patients require a careful, individualized risk-benefit assessment and close clinical monitoring."
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