SGLT2 INHIBITORS IN CHRONIC KIDNEY DISEASE: ADVANCES IN NEPHROPROTECTION AND CURRENT EVIDENCE

<jats:p>Chronic kidney disease (CKD) is a major global public health problem due to its high prevalence, progressive decline in kidney function, and strong association with increased cardiovascular morbidity and mortality. Over the past decades, CKD management has focused primarily on controlling blood pressure, blood glucose, albuminuria, and cardiovascular risk factors through pharmacological strategies aimed at slowing disease progression. Nevertheless, many patients continue to progress to advanced stages of kidney disease, highlighting the need for more effective therapeutic approaches. In this context, sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a major therapeutic innovation, demonstrating renal and cardiovascular benefits that extend beyond glycemic control. This study aimed to analyze the current scientific evidence regarding the use of SGLT2 inhibitors in chronic kidney disease, with emphasis on nephroprotective mechanisms, renal and cardiovascular outcomes, therapeutic safety, and implications for clinical practice. This integrative literature review adopted a qualitative and descriptive approach and was conducted through searches in the PubMed/MEDLINE, SciELO, ScienceDirect, and Cochrane Library databases using Portuguese and English descriptors combined with the Boolean operators AND and OR. The evidence analyzed indicates that SGLT2 inhibitors reduce albuminuria, slow the decline in estimated glomerular filtration rate, decrease the risk of progression to end-stage kidney disease, and reduce major cardiorenal outcomes in eligible patients with and without type 2 diabetes mellitus. It is concluded that this pharmacological class represents a fundamental component of contemporary nephroprotective strategies, and its use should be individualized, supported by the best available scientific evidence, and integrated into continuous clinical follow-up to optimize renal and cardiovascular outcomes and improve the quality of care for patients with chronic kidney disease.</jats:p>