There is controversy within the medical community about giving SGLT2 medications (especially Jardiance and Farxiga) to treat diabetic patients in CKD.
For example, my PCP framed it this way: “Cardiologists like it because it is so effective against heart failure. Nephrologists don’t like it because it is believed to be harmful to the kidneys.” (The latter is based on data from almost a decade ago.)
Here’s a very informed point of view based on recent data…
As far as the preservation of kidney function is concerned, the tortoise wins again! An average SGLT2-treated patient will delay dialysis by 15 years if put on an SGLT2 inhibitor with a RAAS inhibitor (for hypertension).”
So, if we begin treating diabetic patients with SGLT2s, we can postpone kidney failure (ESRD) by as much as 15-20 years! We must educate nephrologists and PCPs about the benefits of SGLT2 medications!
Considering that most CKD patients are hypertensive or diabetic and both and both of these conditions lead to kidney and heart disease, the opinions among physicians in their treatment should NOT be a controversy. Rather, it should be coordinated and based on current data, based on facts, not myths.
Here is the graph summarizing the latest research. Please take a look at recent studies of SGLT2 efficacy and make sure your physicians are informed. I still get pushback from my nephrologists about this. They aren’t up on the latest.