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2026, Vol: 10, Issue: 1
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Review Article
Online Published: 03 Nov 2025
 


SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review

Shahad Abduljalil Abualhamael, Raghad Tawfiq Alasmi, Ruba Eid Alsubhi, Norah Sultan Alharbi, Sirin Mohammed Aljaghthami, Renad Abdullah Alrdeeni, Noor Alfaraj, Alaa Essa Hakami, Buthaynah Abdullah Alharthi, Razan Ghassan Wali, Asmaa Fayez Ahmed Ekram.


Abstract
Heart failure (HF) and chronic kidney disease (CKD) often coexist, driving a maladaptive cardiorenal syndrome with high morbidity and mortality. A systematic review was conducted following PRISMA 2020 guidelines, searching PUBMED, Web of Science, Wiley Online Library, and ScienceDirect databases for studies (2015-2025) of SGLT2 inhibitors and related agents in adults with HF and CKD. Randomized trials and cohort analyses were included if they reported cardiovascular (CV) or renal outcomes. Data on study design, interventions, sample size, outcomes, and safety were extracted and appraised for bias. Across 11 trials (n = 34,999), SGLT2 inhibitors consistently reduced heart failure hospitalizations and CV death by 25-35%, slowed eGFR decline, and showed low rates of acute kidney injury. The subgroup analyses confirmed benefits in preserved and reduced ejection fraction and in CKD stages 2-4. Nonsteroidal MRA finerenone added further event reduction irrespective of SGLT2 background. These findings support SGLT2 inhibition as a cornerstone therapy in cardiorenal syndrome, though optimal initiation timing and combination regimens require further study.

Key words: SGLT2 inhibitors, dapagliflozin, empagliflozin, heart failure, chronic kidney disease, systematic review


 
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How to Cite this Article
Pubmed Style

Abualhamael SA, Alasmi RT, Alsubhi RE, Alharbi NS, Aljaghthami SM, Alrdeeni RA, Alfaraj N, Hakami AE, Alharthi BA, Wali RG, Ekram AFA. SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. IJMDC. 2025; 9(10): 2508-2518. doi:10.24911/IJMDC.51-1756302416

Web Style

Abualhamael SA, Alasmi RT, Alsubhi RE, Alharbi NS, Aljaghthami SM, Alrdeeni RA, Alfaraj N, Hakami AE, Alharthi BA, Wali RG, Ekram AFA. SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. https://www.ijmdc.com/?mno=280067 [Access: December 10, 2025]. doi:10.24911/IJMDC.51-1756302416

AMA (American Medical Association) Style

Abualhamael SA, Alasmi RT, Alsubhi RE, Alharbi NS, Aljaghthami SM, Alrdeeni RA, Alfaraj N, Hakami AE, Alharthi BA, Wali RG, Ekram AFA. SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. IJMDC. 2025; 9(10): 2508-2518. doi:10.24911/IJMDC.51-1756302416


Vancouver/ICMJE Style

Abualhamael SA, Alasmi RT, Alsubhi RE, Alharbi NS, Aljaghthami SM, Alrdeeni RA, Alfaraj N, Hakami AE, Alharthi BA, Wali RG, Ekram AFA. SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. IJMDC. (2025), [cited December 10, 2025]; 9(10): 2508-2518. doi:10.24911/IJMDC.51-1756302416


Harvard Style

Abualhamael, S. A., Alasmi, . R. T., Alsubhi, . R. E., Alharbi, . N. S., Aljaghthami, . S. M., Alrdeeni, . R. A., Alfaraj, . N., Hakami, . A. E., Alharthi, . B. A., Wali, . R. G. & Ekram, . A. F. A. (2025) SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. IJMDC, 9 (10), 2508-2518. doi:10.24911/IJMDC.51-1756302416


Turabian Style

Abualhamael, Shahad Abduljalil, Raghad Tawfiq Alasmi, Ruba Eid Alsubhi, Norah Sultan Alharbi, Sirin Mohammed Aljaghthami, Renad Abdullah Alrdeeni, Noor Alfaraj, Alaa Essa Hakami, Buthaynah Abdullah Alharthi, Razan Ghassan Wali, and Asmaa Fayez Ahmed Ekram. 2025. SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. International Journal of Medicine in Developing Countries, 9 (10), 2508-2518. doi:10.24911/IJMDC.51-1756302416


Chicago Style

Abualhamael, Shahad Abduljalil, Raghad Tawfiq Alasmi, Ruba Eid Alsubhi, Norah Sultan Alharbi, Sirin Mohammed Aljaghthami, Renad Abdullah Alrdeeni, Noor Alfaraj, Alaa Essa Hakami, Buthaynah Abdullah Alharthi, Razan Ghassan Wali, and Asmaa Fayez Ahmed Ekram. "SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review." International Journal of Medicine in Developing Countries 9 (2025), 2508-2518. doi:10.24911/IJMDC.51-1756302416


MLA (The Modern Language Association) Style

Abualhamael, Shahad Abduljalil, Raghad Tawfiq Alasmi, Ruba Eid Alsubhi, Norah Sultan Alharbi, Sirin Mohammed Aljaghthami, Renad Abdullah Alrdeeni, Noor Alfaraj, Alaa Essa Hakami, Buthaynah Abdullah Alharthi, Razan Ghassan Wali, and Asmaa Fayez Ahmed Ekram. "SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review." International Journal of Medicine in Developing Countries 9.10 (2025), 2508-2518. Print. doi:10.24911/IJMDC.51-1756302416


APA (American Psychological Association) Style

Abualhamael, S. A., Alasmi, . R. T., Alsubhi, . R. E., Alharbi, . N. S., Aljaghthami, . S. M., Alrdeeni, . R. A., Alfaraj, . N., Hakami, . A. E., Alharthi, . B. A., Wali, . R. G. & Ekram, . A. F. A. (2025) SGLT2 inhibitors in heart failure and chronic kidney disease: a systematic review. International Journal of Medicine in Developing Countries, 9 (10), 2508-2518. doi:10.24911/IJMDC.51-1756302416




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