Drugs that slow the progression of diabetic kidney disease: are renoprotective effects attenuated in heart failure?

Graphical Abstract Graphical Abstract Top panel: meta-analysis (random effects model) for occurrence of end-stage kidney disease in four major outcomes trials of SGLT2 inhibitors in heart failure. Bottom panel: depiction of different mechanisms driving the progression of chronic kidney disease in type 2 diabetes, as compared with chronic heart failure. Drugs that lower intraglomerular pressures may be beneficial in type 2 diabetes (characterized by glomerular hyperfiltration), but detrimental in chronic heart failure (characterized by glomerular hypofiltration).

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