Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have evolved from a new glucose-lowering medication class to essential treatments for managing cardiovascular and kidney diseases. The review investigates SGLT2 inhibitors through their operational mechanisms and their strong clinical results and their growing medical use cases. The study examines the effects of these inhibitors on disease progression for both diabetic and non-diabetic patients. Background: Sodium-glucose cotransporter 2 inhibitors started as glucose-lowering medications but now serve as drugs that protect both heart and kidney function for every patient who has cardiovascular disease or chronic kidney disease and also present benefits beyond their blood sugar-lowering properties. Objectives: The review studies SGLT2 inhibitors through their cardiovascular and renal benefits together with their operational mechanisms and major clinical trial results, while showing its increasing usage among people who do not have diabetes. Methods: The researchers conducted a complete literature review through PubMed and clinicaltrials.gov to discover important randomized controlled trials and metaanalyses and mechanistic investigations which studied cardiovascular results and heart failure and chronic kidney disease and treatment comparison studies from 2015 until 2025. Key Findings: The trials from EMPA-REG OUTCOME DAPA-HF EMPERORReduced DAPA-CKD and CREDENCE show that SGLT2 inhibitors decrease cardiovascular mortality and heart failure-related hospital admissions and advancing kidney disease at rates between 25 to 39 percent for people with diabetes and those without. Patients start to see advantages within weeks after starting treatment, which continue to exist for an extended period. The cardioprotective mechanisms function through four main processes which include natriuresis, enhanced cardiac energy metabolism, oxidative stress reduction, and decreased myocardial fibrosis. SGLT2 inhibitors provide higher kidney protection to patients than GLP-1 receptor agonists do. Limitations: The majority of clinical studies enrolled white participants, while there was insufficient evidence to study acute coronary syndromes and heart failure with preserved ejection fraction in non-diabetic patients. Conclusions: SGLT2 inhibitors have developed into essential treatment for heart failure and chronic kidney disease because their primary function has changed from glucose reduction. The medication serves as the initial treatment option for protecting heart and kidney health because it demonstrates excellent safety results and strong cardiovascular and kidney protection effects.

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