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Good news for older kidneys (and brains): Two new observational studies presented at Kidney Week 2026 found that SGLT2 inhibitors were associated with a ~27% reduction in mortality and a ~24% lower risk of cognitive impairment in patients aged 65+ with chronic kidney disease. Researchers say there's "no reason to withhold" these drugs based on age alone — though individualized monitoring remains key.
Two observational studies presented at Kidney Week 2026 are making a strong case for expanding SGLT2 inhibitor use in older patients with chronic kidney disease (CKD) — a group historically underrepresented in clinical trials. The first study, using TriNetX data from over 23,000 patients aged 80+, found that SGLT2 inhibitor users had significantly better survival and kidney outcomes compared to non-users over two years. The second study, a national target-trial emulation of adults 65+ with type 2 diabetes and CKD, found that SGLT2 inhibitors were linked to meaningfully lower rates of dementia compared to DPP-4 inhibitors.
Researchers were encouraged by the consistency of benefits across age, sex, BMI, and CKD stage — though they cautioned that the observational design limits causal conclusions and that some adverse events (like candidiasis, ketoacidosis, and acute MI) were higher in SGLT2i users.
By the Numbers:
Why it matters: With CKD disproportionately affecting older adults, these findings challenge the hesitancy around prescribing SGLT2 inhibitors to elderly patients. If confirmed in prospective trials, they could reshape treatment guidelines for one of medicine's most vulnerable — and most overlooked — populations.
