{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:22Z","timestamp":1792384882415,"version":"4.4.0"},"reference-count":61,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sodium\u2010glucose cotransporter 2 (SGLT2) inhibitors have emerged as a cornerstone therapy for chronic kidney disease (CKD) because of their robust cardiorenal protective effects. However, their use in elderly patients remains cautious due to concerns regarding safety, comorbidities and polypharmacy. This review summarises current evidence regarding the efficacy, safety and clinical implementation of SGLT2 inhibitors in elderly individuals with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a narrative literature search of PubMed and Embase for English\u2010language articles published from database inception to May 2026 using combinations of the terms \u2018SGLT2 inhibitor\u2019, \u2018sodium\u2010glucose cotransporter 2 inhibitor\u2019, \u2018chronic kidney disease\u2019, \u2018elderly\u2019, \u2018older adults\u2019, \u2018aging\u2019 and \u2018frailty\u2019. We prioritised randomised controlled trials, meta\u2010analyses, guideline statements and large real\u2010world observational studies reporting kidney, cardiovascular, safety or implementation outcomes relevant to elderly patients with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Subgroup analyses and real\u2010world studies consistently indicate that these benefits are preserved in elderly patients, including those aged \u2265\u200975\u2009years, irrespective of diabetes status or baseline albuminuria. Safety analyses suggest that SGLT2 inhibitors are generally well tolerated in elderly CKD patients. While genital infections, volume depletion and rare cases of euglycemic diabetic ketoacidosis require attention, overall rates of serious adverse events are comparable to placebo and risks of hypoglycemia, fractures and acute kidney injury are not increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite strong guideline recommendations, real\u2010world utilisation of SGLT2 inhibitors in elderly patients remains limited because of clinical inertia, cost barriers and disparities in healthcare access. Future research should focus on frail and very elderly populations, optimal combination therapies and long\u2010term functional outcomes. Overall, current evidence supports the broader and equitable adoption of SGLT2 inhibitors to improve kidney and cardiovascular outcomes in elderly patients with CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71174","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T03:40:14Z","timestamp":1786592414000},"page":"9819-9829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>SGLT2<\/scp>\n                    Inhibitors and Outcomes in Elderly Patients With Chronic Kidney Disease: A Narrative Review"],"prefix":"10.1111","volume":"28","author":[{"given":"Fan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Nephrology Longhua Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijie","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Nephrology Longhua Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2462-3064","authenticated-orcid":false,"given":"Yifei","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Nephrology Longhua Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology Longhua Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.3241"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13020348"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfac024"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.3265\/Nefrologia.pre2014.Feb.12319"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2025.2527092"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaa329"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm2204152"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/9985836"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.14423\/smj.0000000000000235"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15193"},{"key":"e_1_2_15_12_1","first-page":"D7935","article-title":"SGLT2 Inhibitors, Also in Frail Older Adults?","volume":"168","author":"Bruggen D. 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