Table 4.
Clinical research recommendations
| PEOPLE WITH OR WITHOUT TYPE 2 DIABETES | |
| We recommend further research including, wherever possible, randomised trials to establish definitively: | |
| 1 | The effects of SGLT-2 inhibition on cardiac and kidney outcomes in people with polycystic kidney disease |
| 2 | Safety, cardiovascular and kidney effects of SGLT-2 inhibition on kidney outcomes in people with a functioning kidney transplant (see section 7b of the supplementary appendix) |
| 3 | Pharmacokinetics, cardiovascular effects and residual kidney function preservation effects of SGLT-2 inhibition in people on dialysis |
| 4 | The safety and efficacy of adding MRA to SGLT-2 inhibition in people with CKD (particularly non-steroidal MRAs with proven cardiovascular and kidney-related benefits) |
| 5 | The safety and efficacy of combining SGLT-2 inhibition with a glucagon-like peptide-1 (GLP-1) receptor agonists in people with CKD |
| 6 | Detailed cost effectiveness analyses of SGLT-2 inhibition in CKD considering effects across the full range of eGFR and uACR categories |
| FRACTURE RISK | |
| 1 | Establishing any long-term impact of SGLT-2 inhibition on the development and progression of CKD mineral bone disease (CKD-MBD) |
| 2 | Establishing if SGLT-2 inhibition modifies osteoporosis risk posed by thiazolidinediones |
| MULTIMORBIDITY AND FRAILTY | |
| 1 | Future trials of SGLT-2 inhibitor use in people with CKD that seek to extend inclusivity to those of advanced age and multimorbid status |
| PEOPLE WITH TYPE 1 DIABETES | |
| 1 | To establish whether the cardiovascular and kidney benefits of SGLT-2 inhibitors extend to those with type 1 DM |
| 2 | To establish the safety of SGLT-2 inhibitors in people with type 1 DM and chronic kidney disease |
| KIDNEY TRANSPLANT RECIPIENTS | |
| 1 | The generation of reliable randomised trial evidence for transplant recipients is a key research Recommendation |
| ACUTE DECOMPENSATED HEART FAILURE | |
| 1 | Large randomised placebo-controlled clinical trials powered to assess hard clinical outcomes in people with ADHF |