Canagliflozin is an oral diabetes medication that helps control blood sugar levels in patients with type-2 diabetes. Several studies have established the cardiovascular benefits of canagliflozin. However, the effects of canagliflozin on the renal function are not clear. This study aims to evaluate the long-term renal effects of canagliflozin in patients with type-2 diabetes.

This combination of two double-blind, randomized trials included a total of 10,142 participants aged 30 or more with type-2 diabetes. The participants were randomly assigned in a 1:1:1 ratio to receive 300 mg canagliflozin, 100 mg canagliflozin, or matching placebo once daily. The primary outcomes of the study were serum creatinine levels, end-stage kidney disease, or death from renal causes.

The findings suggested that the primary endpoints occurred less in the canagliflozin groups (1.5 per 1,000 person-years) than in the placebo group (2.8 per thousand patient-years). Participants in the canagliflozin groups also exhibited slower annual eGFR decline (difference 1·2 mL/min) and an 18% lower mean UACR. The occurrence of severe renal-related adverse events was similar between the canagliflozin and placebo groups (2.5 vs. 3.3 per 1,000 person-years).

The research concluded that canagliflozin treatment in patients with type-2 diabetes was associated with a reduced risk of eGFR decline, reduction in albuminuria, and loss of kidney function.