Vol. 7, Issue 2, Part A (2025)

Background: Sodium-glucose transport protein 2 inhibitors are beneficial in treating patients with heart failure with preserved ejection fraction, who commonly experience deteriorating kidney function. Sodium-glucose transport protein 2 inhibitors have been found to have a beneficiary effect in reducing the decline in kidney function, as evaluated by the estimated glomerular filtration rate slope. This meta-analysis aimed to determine sodium-glucose transport protein 2 inhibitor treatment-mediated quantitative reduction in the estimated glomerular filtration rate slope in patients with heart failure with preserved ejection fraction. 
Methods: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to identify randomised controlled trials comparing treatment with an sodium-glucose transport protein 2 inhibitor with that of a placebo in evaluating the tendency of decreased kidney function with the estimated glomerular filtration rate slope using PubMed, EBSCOhost, ProQuest, Google Scholar, and Web of Science databases. We performed a random-effects inverse-variance-weighted meta-analysis of the estimated glomerular filtration rate slope outcome. 
Results: A total of two studies involving 12250 patients of 585 initially identified studies were included in the final analysis. Reduction in estimated glomerular filtration rate slope was significantly different between patients treated with sodium-glucose transport protein 2 inhibitors and those administered placebo (Mean difference = 0.94, 95% Confidence Interval = 0.09-1.80, P = 0.03, I2 = 92%, Low Quality). 
Conclusion: A substantial reduction was observed in the estimated glomerular filtration rate slope in sodium-glucose transport protein 2-treated patients by 0.94 ml/min per 1.73 m2, which was almost the same as that found in the normal population. Further research is needed to improve study quality and better evaluate the effect of sodium-glucose transport protein 2 inhibitors treatment on improved kidney function in patients with heart failure with preserved ejection fraction.