Table 1.

Current indications for SGLT2 inhibitors

Indication	Criteria	Kidney function
Congestive heart failure	•NYHA classes II–IV •Elevated NT-proBNP •All ejection fractions	•eGFR >20 ml/min per 1.73 m2
Glycemic control or metabolic risk	•Type 2 diabetes mellitus •First-line for glycemic control (along with metformin)	•eGFR ≥60 ml/min per 1.73 m2 •Anticipated HbA1c ↓: 0.6%–0.9% •Anticipated weight ↓: 2–3 kg
		•eGFR 45–59 ml/min per 1.73 m2 •Anticipated HbA1c ↓: 0.3%–0.5% •Anticipated weight ↓: 1–2 kg
		•eGFR < 45 ml/min per 1.73 m2 •Anticipated HbA1c ↓: minimal •Anticipated weight ↓: 1–2 kg
Reduction in ASCVD	•Type 2 diabetes mellitus •Established ASCVD or high risk for ASCVDa	•eGFR ≥ 30 ml/min per 1.73 m2
Diabetic kidney disease	•Type 2 diabetes mellitus	•eGFR ≥25 ml/min per 1.73 m2 •UACR 200–5000 mg/gb
Nondiabetic kidney disease	•Etiology of kidney disease: ischemic nephropathy, IgA nephropathy, FSGS, chronic pyelonephritis, chronic interstitial nephritis •No immunosuppression in prior 6 mo	•eGFR ≥ 25 ml/min per 1.73 m2 •UACR 200–5000 mg/gb

ASCVD, atherosclerotic cardiovascular disease; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; eGFR, estimated glomerular filtration rate (CKD-EPI); FSGS, focal segmental glomerulosclerosis; HbA1c, hemoglobin A1c; LDL, low-density lipoprotein; NT-proBNP, N-terminal pro-brain natriuretic peptide; NYHA, New York Heart Association; UACR, urine microalbumin-to-creatinine ratio.

^aAtherosclerotic cardiovascular disease is defined as ischemic heart disease, ischemic cerebrovascular disease, or peripheral artery disease. High risk for atherosclerotic cardiovascular disease is defined as age ≥55 years in men and ≥60 years in women and one or more of the following risk factors: hypertension, dyslipidemia (LDL >130 mg/dl or use of lipid-lowering therapies), or tobacco use.

^bThe EMPA-KIDNEY trial was stopped early for efficacy and included patients with diabetic kidney disease and nondiabetic kidney disease with eGFR 20 to 45 ml/min per 1.73 m² regardless of UACR or eGFR 45 to 90 ml/min per 1.73 m² with UACR ≥200 mg/g; however, results have not yet been presented or published.