{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:45:12Z","timestamp":1782751512753,"version":"3.54.5"},"reference-count":37,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kidney Blood Press Res"],"abstract":"<jats:p>Introduction: Nondiabetic kidney disease (NDKD) is a major contributor to chronic kidney disease worldwide. Although renin-angiotensin system inhibitors (RASi) remain standard therapy, sodium-glucose cotransporter-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonists (non-steroidal MRAs), and glucagon-like peptide-1 receptor agonists are now recommended in clinical guidelines. However, direct comparative evidence to guide their prioritization in NDKD is limited. Methods: We performed a systematic review and Bayesian network meta-analysis of randomized controlled trials enrolling adults with NDKD. The primary endpoint was the annualized change in estimated glomerular filtration rate (eGFR) slope; secondary endpoints included urine protein-to-creatinine ratio (UPCR), blood pressure, and biochemical safety parameters. Results: Eighteen trials were included. SGLT2i, as add-on to RASi, produced the greatest preservation of kidney function compared with RASi alone (mean difference [MD] 12.1 mL\/min\/1.73 m2\/year; 95% credible interval [CrI] 3.9 to 20.4). Non-steroidal MRA achieved the largest reduction in proteinuria versus RASi (UPCR MD \u22120.4 g\/g; 95% CrI: \u22121.0 to \u22120.2). SGLT2i also yielded the greatest systolic blood pressure reduction versus RASi (MD \u22129.1 mm Hg vs. RASi; 95% CrI: \u221211.7 to \u22126.5). Surface-under-the-cumulative-ranking probabilities identified SGLT2i as most effective for eGFR slope preservation (99.8%) and non-steroidal MRA as most effective for proteinuria reduction (98.8%). Safety analyses showed a mild, expected hemoglobin decrease with SGLT2i and a nonsignificant creatinine rise with non-steroidal MRA. Conclusions: SGLT2i and non-steroidal MRA confer distinct renal benefits in NDKD \u2013 SGLT2i primarily preserve kidney function, whereas non-steroidal MRAs most effectively reduce proteinuria. These results support a phenotype-driven therapeutic framework and highlight the need for head-to-head trials to validate precision-guided treatment strategies in NDKD.<\/jats:p>","DOI":"10.1159\/000552201","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T16:00:53Z","timestamp":1777046453000},"page":"409-420","source":"Crossref","is-referenced-by-count":0,"title":["Divergent Renal Benefits of Sodium-Glucose Cotransporter-2 Inhibitors and Mineralocorticoid Receptor Antagonists in Nondiabetic Kidney Disease"],"prefix":"10.1159","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7714-5529","authenticated-orcid":false,"given":"Rulong","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiating","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingfei","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunpeng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoyong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-5732","authenticated-orcid":false,"given":"Jihong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-022-01340-x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-019-01324-7"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-018-0001-y"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1124\/pharmrev.120.000236"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2009.186"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2021.09.014"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-022-01637-0"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvae047"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000540"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-54009-3"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30162-5"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-024-04099-1"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-023-03539-8"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2024.10.019"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2025.01.023"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/s0272-6386(96)90158-4"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.28.865"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2007.00786.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2011.118059"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.advms.2014.03.003"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2310\/JIM.0b013e31826741d2"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaa085"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03327-6"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307563"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03015-5"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfad249"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaf125"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S531236"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-02767-9"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2024.03.019"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa736"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.70075"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-024-01723-6"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021070942"}],"container-title":["Kidney 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