SGLT2 inhibitors significantly reduced Cholesterol Levels in CKD Patients: Study

A new study published in the Metabolites journal found that SGLT2 inhibitors (SGLT2i) significantly reduced total cholesterol levels in all chronic kidney disease (CKD) patients over a 24-month period, irrespective of their diabetes mellitus (DM) status. However, no notable changes were observed in triglycerides (Tg), LDL cholesterol (LDLc), or HDL cholesterol (HDLc) levels.

The study analyzed the medical records of 75 patients diagnosed with CKD who had been on SGLT2i therapy. Key biochemical markers, kidney function indicators, and blood pressure readings were compared between baseline values and those taken two years into the treatment.

The study found a statistically significant reduction in total cholesterol (Chol) levels across all participants, regardless of whether they had diabetes mellitus. While triglycerides (Tg) and low-density lipoprotein cholesterol (LDLc) also trended downward, these changes were not statistically significant. High-density lipoprotein cholesterol (HDLc) levels showed a slight increase, though again, this was not significant enough to draw strong conclusions.

Despite expectations, creatinine clearance (Ccr), a marker of kidney filtration ability, showed a significant decrease over the 24-month period, suggesting some progression of kidney function impairment. Serum urea (Sur), another marker of declining renal performance, significantly increased. However, levels of proteinuria (Prt), a key indicator of kidney damage, remained stable, suggesting that SGLT2i may have a protective effect on kidney structure even as filtration metrics fluctuate.

Blood pressure outcomes revealed a significant reduction in diastolic blood pressure (DBP), which could contribute to cardiovascular risk reduction in this patient population. This adds to the growing body of evidence supporting the cardiovascular benefits of SGLT2 inhibitors.

The study concluded that SGLT2 inhibitors appear to contribute to better cholesterol control and some cardiovascular benefits in CKD patients, with a complex but manageable impact on renal function. These findings reinforce the role of SGLT2i in holistic CKD management and may prompt further prospective studies to explore their long-term outcomes and mechanisms of action.

Overall, this study highlights the growing interest in SGLT2i therapies not just for their glucose-lowering abilities in diabetic patients, but also for their broader implications in CKD management, particularly in improving lipid profiles and offering mild blood pressure benefits.

Source:

Gajić, S., Janković, S., Stojadinović, M., Filić, K., Bontić, A., Pavlović, J., Mrđa, I., Petrović, K., Hadži-Tanović, L., Žunić, J., Kostić, M., Kezić, A., & Baralić, M. (2025). The effects of SGLT2 inhibitors on lipid profile and kidney function in patients with chronic kidney disease regardless of diabetes and hypertension status. Metabolites, 15(4). https://doi.org/10.3390/metabo15040271