---
title: "Changes in cardiorenal risk scores after SGLT2 inhibitor start in CKD patients with and without ty"
id: "pubmed-42592709"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42592709"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42592709/"
doi: "10.1093/joneph/aajag105"
published_at: "2026-10-10T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Changes in cardiorenal risk scores after SGLT2 inhibitor start in CKD patients with and without ty
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42592709
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42592709/)
- **DOI:** [10.1093/joneph/aajag105](https://doi.org/10.1093%2Fjoneph%2Faajag105)
- **Published At:** 2026-10-10T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective, propensity score–matched cohort study evaluated 132 patients with **chronic kidney disease (CKD)** who started **SGLT2 inhibitors (SGLT2i)** and were followed for 12 months; groups comprised 66 patients with type 2 diabetes (T2D) and 66 without T2D. - Cardiovascular and renal risk were assessed at baseline and 12 months using three validated tools: **PREVENT**, **SCORE2 with CKD Add-on (SCORE2‑CKD)**, and the **Kidney Failure Risk Equation (KFRE)**. - In the diabetic subgroup, PREVENT scores declined significantly over 12 months (Δ -2.95, P = .001), indicating an improvement in predicted cardiovascular risk; non-diabetic patients showed no significant PREVENT change (Δ -0.80, P = .396). - SCORE2‑CKD decreased in patients with diabetes (Δ -3.85, 95% CI -4.35 to -3.35, P = .023) but increased unexpectedly in non-diabetic patients (Δ +3.25, P = .044). - **KFRE**-derived renal risk decreased significantly in both diabetic and non-diabetic groups over 12 months, indicating improvement in predicted kidney-failure risk after SGLT2i initiation. - Patients with higher baseline cardiovascular risk experienced the largest declines in PREVENT and SCORE2‑CKD. - Across the whole cohort, changes in **eGFR** and **proteinuria** were independent predictors of improvement in cardiovascular risk scores. - Authors caution these are exploratory changes in predicted risk scores rather than observed reductions in cardiovascular events; results are reported from a real-world CKD cohort and should be interpreted accordingly. - The study used 1:1 propensity matching and logistic regression to analyze score changes and predictors; full patient-level characteristics and additional methodological details were reported in the source article.
## Clinical Analysis & Structured Key Points
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Annunziata', Cosenza, Italy."), [Sasha Albertini](https://pubmed.ncbi.nlm.nih.gov/?term=Albertini+S&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Sabrina Berti](https://pubmed.ncbi.nlm.nih.gov/?term=Berti+S&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Ilirjana Sanfilippo](https://pubmed.ncbi.nlm.nih.gov/?term=Sanfilippo+I&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Valentina Vicennati](https://pubmed.ncbi.nlm.nih.gov/?term=Vicennati+V&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-3 "Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy."), [Uberto Pagotto](https://pubmed.ncbi.nlm.nih.gov/?term=Pagotto+U&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-3 "Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy."), [Gaetano La Manna](https://pubmed.ncbi.nlm.nih.gov/?term=La+Manna+G&cauthor_id=42592709)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-1 "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Giuseppe Cianciolo](https://pubmed.ncbi.nlm.nih.gov/?term=Cianciolo+G&cauthor_id=42592709)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#full-view-affiliation-1 "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.") Affiliations Expand ### Affiliations * 1 Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. * 2 Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy. * 3 Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. * 4 Nephrology, Dialysis and Renal Transplant Unit, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende - Hospital 'SS. Annunziata', Cosenza, Italy. * PMID: **42592709** * DOI: [ 10.1093/joneph/aajag105 ](https://doi.org/10.1093/joneph/aajag105) Free article Item in Clipboard # Longitudinal changes in cardiorenal risk scores after SGLT2 inhibitor initiation in patients with CKD with and without type 2 diabetes Irene Capelli et al. J Nephrol. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID J Nephrol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Nephrol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Nephrol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42592709/) . 2026 Oct 10;39(6):1246-1256. doi: 10.1093/joneph/aajag105. ### Authors [Irene Capelli](https://pubmed.ncbi.nlm.nih.gov/?term=Capelli+I&cauthor_id=42592709)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-1 "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Daniele Vetrano](https://pubmed.ncbi.nlm.nih.gov/?term=Vetrano+D&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Danilo Ribichini](https://pubmed.ncbi.nlm.nih.gov/?term=Ribichini+D&cauthor_id=42592709)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-3 "Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy."), [Michele Provenzano](https://pubmed.ncbi.nlm.nih.gov/?term=Provenzano+M&cauthor_id=42592709)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-4 "Nephrology, Dialysis and Renal Transplant Unit, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende - Hospital 'SS. Annunziata', Cosenza, Italy."), [Sasha Albertini](https://pubmed.ncbi.nlm.nih.gov/?term=Albertini+S&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Sabrina Berti](https://pubmed.ncbi.nlm.nih.gov/?term=Berti+S&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Ilirjana Sanfilippo](https://pubmed.ncbi.nlm.nih.gov/?term=Sanfilippo+I&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Valentina Vicennati](https://pubmed.ncbi.nlm.nih.gov/?term=Vicennati+V&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-3 "Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy."), [Uberto Pagotto](https://pubmed.ncbi.nlm.nih.gov/?term=Pagotto+U&cauthor_id=42592709)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-3 "Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy."), [Gaetano La Manna](https://pubmed.ncbi.nlm.nih.gov/?term=La+Manna+G&cauthor_id=42592709)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-1 "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-2 "Department of Medical and Surgical Sciences \(DIMEC\), Alma Mater Studiorum University of Bologna, Bologna, Italy."), [Giuseppe Cianciolo](https://pubmed.ncbi.nlm.nih.gov/?term=Cianciolo+G&cauthor_id=42592709)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42592709/#short-view-affiliation-1 "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.") ### Affiliations * 1 Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. * 2 Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy. * 3 Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. * 4 Nephrology, Dialysis and Renal Transplant Unit, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende - Hospital 'SS. Annunziata', Cosenza, Italy. * PMID: **42592709** * DOI: [ 10.1093/joneph/aajag105 ](https://doi.org/10.1093/joneph/aajag105) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Background:** Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have become the standard of care in managing chronic kidney disease (CKD) and heart failure (HF), both in patients with and without type 2 diabetes mellitus (T2DM). Nonetheless, identifying those at persistent high cardiovascular (CV) and renal risk remains critical. **Methods:** We conducted a retrospective, 1:1 propensity-matched cohort study involving 132 CKD patients (66 with T2D and 66 without). Participants were followed for 12 months after SGLT2i initiation. Cardiovascular and renal risk were assessed using three validated tools-PREVENT, SCORE2 with CKD Add-on (SCORE2-CKD), and Kidney Failure Risk Equation (KFRE)-calculated at baseline and at 12-month follow-up. Changes in risk scores were analyzed, and logistic regression was used to identify predictors of improvement. **Results:** After 12 months, PREVENT scores declined significantly in the diabetic subgroup (Δ -2.95, P = .001), whereas non-diabetic patients showed no significant change (Δ -0.80, P = .396). SCORE2-CKD also decreased in diabetics (Δ -3.85, 95% CI -4.35 to -3.35, P = .023) but unexpectedly increased in non-diabetic patients (Δ + 3.25, P = .044). Importantly, individuals at higher baseline risk exhibited the most pronounced declines in both PREVENT and SCORE2-CKD. KFRE-derived renal risk decreased significantly in both groups. Across the entire cohort, variation in estimated glomerular filtration rate (eGFR) and proteinuria were independent predictors of CV risk-score improvement. **Conclusions:** In this real-world CKD cohort, SGLT2 inhibitor initiation was associated with favorable changes in renal risk scores and with changes in cardiovascular risk estimates, particularly among patients with diabetes and at higher baseline risk. These findings should be interpreted as exploratory changes in predicted risk rather than as evidence of reduction in observed cardiovascular events. **Keywords:** Cardiovascular risk prediction; Chronic kidney disease; Kidney failure risk prediction; Sodium-glucose cotransporter-2 inhibitors. © The Author(s) 2026. Published by Oxford University Press on behalf of Societa Italiana Nefrologia/Italian Society of Nephrology; Society ownership. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Conflicts of interest: The authors declare no conflicts of interest related to the content of this manuscript. ## MeSH terms * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42592709/) * Cardiovascular Diseases* / diagnosis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cardiovascular+Diseases%2Fdiagnosis%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cardiovascular+Diseases) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42592709/) * Cardiovascular Diseases* / etiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cardiovascular+Diseases%2Fetiology%22%5BMAJR%5D&sort=date&sort_order
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