UK Study: SGLT2 Inhibitors Protect Kidneys With or Without Diabetes

A study from the United Kingdom, conducted by researchers at the University of Oxford's Nuffield Department of Population Health, has delivered some of the most compelling evidence yet that a widely used class of diabetes medications offers broad kidney-protective benefits — even in patients who do not have diabetes.

What Did the Researchers Study?

The Oxford team analyzed data from 8 major randomized clinical trials involving nearly 58,816 participants to evaluate the effects of SGLT2 inhibitors — medications like empagliflozin (Jardiance), dapagliflozin (Farxiga), and canagliflozin (Invokana) — on kidney outcomes. Participants were grouped by diabetes status and by levels of a key kidney health marker called urine albumin-to-creatinine ratio (UACR), which measures protein leakage in the urine. A UACR of 200 mg/g or higher signals more significant kidney stress.

What Did They Find?

The results were striking across the board:

• Kidney disease progression was reduced by 35% in people with diabetes and 26% in people without diabetes, compared to placebo.
• Acute kidney injury rates dropped by 23% in those with diabetes and 28% in those without.
• Hospitalizations fell by roughly 10% in both groups — meaning approximately 29–34 fewer hospitalizations per 1,000 patients annually.
• Death rates were meaningfully lower in participants with diabetes (14% reduction), with a similar trend in those without diabetes.

Importantly, benefits were seen regardless of UACR level, though patients with higher protein levels in their urine (UACR ≥ 200 mg/g) — equivalent to more advanced kidney stress — experienced the largest absolute kidney-protection benefits.

Why the UK Perspective Matters

The UK's National Health Service manages one of the world's largest integrated patient datasets, giving Oxford researchers access to diverse, real-world clinical trial populations across multiple countries. This broad international evidence base strengthens confidence that findings translate directly to American patients, regardless of race, age, or healthcare setting.

How Does This Compare to US Guidelines?

Current American Diabetes Association (ADA) and KDIGO (Kidney Disease: Improving Global Outcomes) guidelines already recommend SGLT2 inhibitors for people with type 2 diabetes and chronic kidney disease. However, guidance for patients without diabetes who have CKD has been less definitive. This Oxford meta-analysis — published in JAMA in 2026 — provides strong new evidence that US guidelines may need to broaden recommendations to cover non-diabetic kidney disease patients more explicitly.

Why This Matters for US Patients

Chronic kidney disease affects an estimated 37 million Americans, and many do not have diabetes. This study signals that millions more patients could benefit from SGLT2 inhibitors than currently receive them. If you have CKD — with or without diabetes — and your UACR is elevated (ask your doctor for this simple urine test), this research strongly suggests that an SGLT2 inhibitor conversation is worth having at your next appointment. These medications are already FDA-approved for kidney protection in certain populations, and this evidence supports their broader use.

Talk to your doctor before starting or changing any medication. Individual kidney function (eGFR) and other health factors will guide whether an SGLT2 inhibitor is appropriate for you.

Citation

Staplin N, Roddick A, Neuen BL, et al. Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria: A Meta-Analysis. JAMA. 2026. PMID: 41202026. DOI: 10.1001/jama.2025.20835