Renal Protection at a Metabolic Cost: A Systematic Review and Meta-Analysis of Perioperative Use of Sodium-Glucose Cotransporter 2 Inhibitors.

ABSTRACT:

Introduction

Concerns about diabetic ketoacidosis (DKA) and euglycemic ketoacidosis (eKA) are balanced against possible organ-protective benefits in the debated perioperative management of sodium-glucose cotransporter-2 (SGLT2) inhibitors. This meta-analysis compared the perioperative clinical and laboratory outcomes associated with perioperative exposure to SGLT2i.

Methods

Through July 31, 2025, we searched PubMed, Web of Science, Scopus, and CENTRAL for observational studies and randomised controlled trials comparing the outcomes of preoperative use of SGLT2 inhibitors with non-use in patients undergoing cardiac or non-cardiac surgery. We pooled data using a random-effects model and investigated heterogeneity using leave-one-out sensitivity analyses.

Prospero-id

CRD

SUBMITTER: Balbaa E 

PROVIDER: S-EPMC12928041 | biostudies-literature | 2026 Mar

REPOSITORIES: biostudies-literature