Relationship between sodium-glucose cotransporter 2 inhibitors and kidney neoplasm: systematic review and meta-analysis

Mohammadreza Nowroozi; Ali Khalilzadeh; Seyed Amir Banikarim; Houshang Sanadgol; Rasoul Jafari Arismani; Ahmadreza Maghsoudi; Peyman Khajehnabi; Zahed Karimi; Naeem Nikpour

doi:10.34172/jnp.2026.27706

J Nephropathol. 2026;15(3): e27706.
doi: 10.34172/jnp.2026.27706

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Meta-analysis

Relationship between sodium-glucose cotransporter 2 inhibitors and kidney neoplasm: systematic review and meta-analysis

Mohammadreza Nowroozi ¹ , Ali Khalilzadeh ¹ , Seyed Amir Banikarim ² , Houshang Sanadgol ³ , Rasoul Jafari Arismani ⁴ , Ahmadreza Maghsoudi ⁵ , Peyman Khajehnabi ⁶ , Zahed Karimi ⁷ , Naeem Nikpour ⁸^*

¹ Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
² Hematology-Oncology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
³ Department of Nephrology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
⁴ Department of Urologic Surgery, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
⁵ Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
⁶ Department of Pharmacology, Cyprus International University, Lefkosa, North Cyprus
⁷ Department of Internal Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
⁸ Department of Hematology and Medical Oncology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

*Corresponding Author: Naeem Nikpour, Email: Dr.nikpour1360@gmail.com

Abstract

Introduction: Kidney cancer is a common tumor of the urinary system, and existing data on the relationship between sodium–glucose cotransporter 2 (SGLT2) inhibitors use and kidney cancer are inconsistent. Therefore, this study aimed to investigate the association between SGLT2 inhibitor use and the risk of developing kidney cancer.

Materials and Methods: This study was designed as a systematic review and meta-analysis following the PRISMA guidelines. Accordingly, a comprehensive search was conducted in the Cochrane, Scopus, Web of Science, Embase, and PubMed databases, as well as the Google Scholar search engine, up to January 5, 2026. Data analysis was performed using STATA version 14.

Results: The results showed that the association between the use of SGLT2 inhibitors (OR: 1.14, 95% CI: 0.86–1.52), dapagliflozin (OR: 1.67, 95% CI: 0.47–5.93), canagliflozin (OR: 1.59, 95% CI: 0.61–4.15), and empagliflozin (OR: 1.31, 95% CI: 0.52–3.27) with the risk of kidney cancer was not statistically significant. However, SGLT2 inhibitor use was associated with a reduced risk of renal cell carcinoma (RCC) (OR: 0.69, 95% CI: 0.63–0.76). In contrast, compared with dipeptidyl peptidase‑4 (DPP‑4) inhibitors, SGLT2 inhibitor use was linked to an increased risk of kidney cancer (OR: 1.64, 95% CI: 1.11–2.43).

Conclusion: In conclusion, the use of SGLT2 inhibitors did not affect the incidence of kidney cancer, but it was associated with a 31% reduction in the risk of RCC. In contrast, compared with DPP‑4 inhibitors, SGLT2 inhibitor use increased the risk of kidney cancer by 64%.

Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420261293668) and Research Registry (UIN; reviewregistry2078) websites.

Keywords: SGLT-2 inhibitor, Kidney neoplasms, Gliflozins, Renal cancer, Sodium-glucose cotransporter 2 inhibitors, Kidney neoplasm

Implication for health policy/practice/research/medical education:

The results indicated that sodium–glucose cotransporter 2 (SGLT2) inhibitor therapy did not influence the overall occurrence of kidney cancer, yet it was linked to a 31% reduction in the risk of renal cell carcinoma (RCC). However, when compared with dipeptidyl peptidase‑4 inhibitors (DPP‑4), SGLT2 inhibitors were associated with a 64% higher likelihood of kidney cancer. Clinically, these findings underscore the importance of individualized drug selection in diabetes management, prompting clinicians to strike a balance between potential oncologic risks and benefits when choosing between glucose-lowering therapies.

Please cite this paper as: Nowroozi M, Khalilzadeh A, Banikarim SA, Sanadgol H, Jafari Arismani R, Maghsoudi A, Khajehnabi P, Karimi Z, Nikpour N. Relationship between sodium-glucose cotransporter 2 inhibitors and kidney neoplasm: systematic review and meta-analysis. J Nephropathol. 2026;15(3):e27706. DOI: 10.34172/jnp.2026.27706.