Table 2 Summary of Recommendations for Use

PEOPLE WITH TYPE 2 DM

Grade

1

We recommend initiating SGLT-2 inhibition in people with chronic kidney disease and type 2 diabetes, irrespective of primary kidney disease,^a for any of the following 4 clinical scenarios:

a) eGFR of 20–45 mL/min/1.73m²

b) eGFR of > 45 mL/min/1.73m² and a urinary albumin-to-creatinine ratio (uACR) of ≥ 25 mg/mmol^b

c) Symptomatic heart failure, irrespective of ejection fraction

d) Established coronary disease

1A

2

We suggest initiating SGLT-2 inhibition to modify cardiovascular risk and slow rate of kidney function decline in people with an eGFR > 45–60 mL/min/1.73m² and a uACR of < 25 mg/mmol, recognising effects on glycaemic control will be limited

2B

3

We suggest clinicians consider initiating SGLT-2 inhibition in people with an eGFR below 20 mL/min/1.73m² to slow progression of kidney disease

2B

PEOPLE WITHOUT DM

1

We recommend initiating SGLT-2 inhibition in people with chronic kidney disease, irrespective of primary kidney disease,^a for any of the following clinical scenarios:

(a) eGFR of ≥ 20 mL/min/1.73m² and a urinary albumin-to-creatinine ratio (uACR) of ≥ 25 mg/mmol^b

(b) Symptomatic heart failure, irrespective of ejection fraction

1A

2

We recommend initiating SGLT-2 inhibition to slow rate of kidney function decline in people with an eGFR of 20–45 mL/min/1.73m² and a uACR of < 25 mg/mmol^b

1B

3

We suggest clinicians consider initiating SGLT-2 inhibition in people with an eGFR below 20 mL/min/1.73m² to slow progression of kidney disease

2B