The composite endpoint consisted of sustained doubling of serum creatinine, end-stage kidney disease, and death from renal causes.
The CANVAS Program was designed to establish cardioprotective effects of canagliflozin in patients with type 2 diabetes with (or with risk factors for) cardiovascular disease. It was not specifically designed to evaluate renal outcomes, and a related comment notes that the results of dedicated renal outcome trials are needed before SGLT2 inhibitors can be routinely used in patients with diabetic kidney disease. These studies should include patients that are at substantially higher risk of renal events than those enrolled in current cardiovascular outcome trials, ensure long-term follow-up, and use regulatory agency-approved and generally accepted renal endpoints and appropriate measurements.