Table 4.

Dose adjustments for eGFR <45 mL/min/1.73 m² (information presented reflects the package inserts rather than guidance from this consensus report)

^*Glucose-lowering efficacy is reduced with SGLT2i as eGFR declines, but kidney and cardiovascular benefits are preserved.

^†Dapagliflozin is approved for use at 10 mg once daily with an eGFR of 25 to <45 mL/min/1.73 m².

^‡Initiation not recommended with eGFR <30 mL/min/1.73 m² for glycemic control or <20 mL/min/1.73 m² for HF. Higher dose can be used but is not effective for glucose lowering and does not offer further clinical benefit in this range of eGFR.

^§Dulaglutide, liraglutide, and injectable semaglutide have demonstrated evidence of cardiovascular benefit in large cardiovascular outcome trials.

CV, cardiovascular; DPP-4, dipeptidyl peptidase 4; GFR, estimated glomerular filtration rate; GLP-1, glucagon-like peptide 1; SGLT2, sodium–glucose cotransporter 2.