Inibidores de SGLT2 e proteção renal: evidências científicas e impacto na progressão da doença renal crônica

Chronic kidney disease represents a condition of considerable epidemiological importance, characterized by persistent deterioration of renal function and associated with an increased likelihood of cardiovascular complications and fatal outcomes. In this context, sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a therapeutic strategy capable of slowing the progression of kidney disease, including in patients without diabetes mellitus. This study aims to analyze the scientific evidence regarding the impact of SGLT2 inhibitors on slowing the progression of chronic kidney disease, considering outcomes related to renal function, albuminuria, renoprotective mechanisms, and therapeutic safety. This study consists of an integrative literature review with a qualitative approach and descriptive design, focusing on publications from the past ten years. The synthesis encompasses randomized controlled trials, meta-analyses, observational studies, and clinical practice guidelines relevant to the topic. The studies reviewed indicate that SGLT2 inhibitors exert renoprotective effects, contributing to the deceleration of kidney dysfunction progression, the preservation of glomerular filtration capacity, and the reduction of albuminuria in patients with different clinical profiles. These benefits appear to result from mechanisms extending beyond glycemic control, including modulation of tubuloglomerular feedback, reduction of intraglomerular pressure, and potential metabolic and cellular effects. Despite their favorable safety profile, the use of these medications requires individualized assessment, with particular attention to volume status, genital infections, and the risk of ketoacidosis in specific circumstances. It is concluded that SGLT2 inhibitors represent an important therapeutic option for renal protection and should be considered in the management of eligible patients, in combination with other measures aimed at reducing renal and cardiovascular risk.