Cardiorenal Benefits of SGLT2 Inhibitors Beyond Diabetes: Sandra Chaparro, MD

Sodium-glucose cotransporter-2 (SGLT2) inhibitors should be viewed as cardiorenal-protective therapies for a broad range of patients with chronic kidney disease (CKD), not solely as glucose-lowering agents for individuals with diabetes, according to Sandra Chaparro, MD, director of Advanced Heart Failure at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida.

Chaparro emphasizes that SGLT2 inhibitors consistently improve cardiovascular outcomes and help patients live longer, stay out of the hospital, and delay or avoid dialysis.

The key clinical question, she argues, is no longer whether a patient has diabetes, but whether clinicians want to optimize long-term kidney and cardiovascular health. Despite this, underuse persists, driven largely by lack of awareness among some providers about the full scope of benefits and by overestimation of potential side effects, which she attributes to insufficient education on the risk-benefit profile.

Cost and access remain meaningful barriers. High co-payments can limit patient uptake even as generic formulations begin to appear. However, Chaparro is hopeful that, over the coming months, prior authorization requirements will ease, improving timely access. She stresses that nephrologists already rely on albuminuria and serum creatinine as key markers of renal function and notes that SGLT2 inhibitors have been shown to improve both parameters.

Importantly, emerging data now support the use of SGLT2 inhibitors in patients with an estimated glomerular filtration rate as low as 20 mL/min/1.73 m², extending benefits across a wide spectrum of CKD severity and reinforcing the need to integrate these agents into routine kidney care.