If you have kidney disease and protein in your urine (proteinuria), your doctor may recommend a newer class of medications called SGLT2 inhibitors. These medicines were first used to treat diabetes, but they are now widely used to protect the kidneys and heart — even in some patients without diabetes.

What Are SGLT2 Inhibitors?

SGLT2 inhibitors are oral medications that help the kidneys remove extra sugar and salt through the urine. Common examples include:

• Empagliflozin (Jardiance®)

• Dapagliflozin (Farxiga®)

• Canagliflozin (Invokana®)

These medications have been shown in large clinical trials to slow kidney damage and reduce proteinuria.

How Do SGLT2 Inhibitors Help with Proteinuria?

SGLT2 inhibitors lower pressure inside the kidney filters (glomeruli). This helps:

• Reduce protein leakage into the urine

• Slow the loss of kidney function

• Protect against kidney failure

• Lower the risk of heart failure and heart disease

Reducing proteinuria is a key goal because it helps preserve kidney health long-term.

Benefits Beyond Blood Sugar Control

Even though these medicines lower blood sugar, their kidney benefits go beyond diabetes control. SGLT2 inhibitors can:

• Protect kidney function

• Lower blood pressure slightly

• Reduce fluid overload

• Decrease risk of heart failure hospitalization

• Reduce cardiovascular events

Because of these benefits, SGLT2 inhibitors are now standard treatment for many patients with chronic kidney disease and proteinuria.

Common Side Effects to Know About

Most patients tolerate SGLT2 inhibitors well, but possible side effects include:

• Increased urination

• Genital yeast infections

• Urinary tract infections (less common)

• Mild dehydration or low blood pressure

• Temporary small drop in kidney function when starting

Your nephrologist will monitor your labs and symptoms to make sure the medication is safe for you.

Who Should Be Monitored Closely?

Patients who especially need close monitoring include those who:

• Have advanced kidney disease

• Take diuretics (water pills)

• Have low blood pressure

• Have a history of frequent infections

• Are at risk for dehydration

Why Nephrology Follow-Up Is Important

Starting and continuing SGLT2 inhibitors should be guided by a kidney specialist. Your nephrologist will:

• Check kidney function and urine protein

• Adjust other medications

• Monitor electrolytes and blood pressure

• Watch for side effects

• Make sure you get maximum kidney protection

Key Takeaway

SGLT2 inhibitors are one of the most important advances in treating proteinuria and chronic kidney disease. When used appropriately, they can significantly slow kidney damage and reduce the risk of kidney failure and heart disease.

If you have protein in your urine, ask your nephrologist if an SGLT2 inhibitor may be right for you.