NICE recommendations (TA942)
- Empagliflozin is recommended for CKD in adults as an add-on to optimised standard care including the highest tolerated ACEi/ARB dose (unless contraindicated).
- Eligibility includes eGFR 20 to <45, or eGFR 45 to 90 with uACR ≥22.6 mg/mmol or type 2 diabetes.
- If suitable options include dapagliflozin, NICE advises using the least expensive after discussion.
Primary care monitoring (high-yield)
- Baseline: eGFR/uACR, BP, volume status; review diuretics and sick-day rules.
- Counsel: genital infections, dehydration, rare ketoacidosis; pause in acute illness/fasting/surgery per local protocol.
Frequently asked questions
Is albuminuria required?
Not if the person has type 2 diabetes; otherwise uACR ≥22.6 is part of the eGFR 45–90 eligibility.
How low an eGFR can be started?
TA942 includes initiation down to eGFR 20 ml/min/1.73m² within the specified criteria.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.