Abstract: Anemia is a common complication of chronic kidney disease (CKD), which significantly affects the quality of life of patients and is closely related to the progression of various chronic diseases. Sodium⁃glucose cotransporter 2 inhibitors (SGLT2i) were initially used to improve glycemic control in patients with diabetes. However, in recent years, studies have found that SGLT2i not only delay the progression of CKD, but also show significant effects in improving anemia. Research indicates that SGLT2i alleviate hypoxia in the proximal renal tubules to restore the vitality of fibroblast⁃like cells in the renal interstitium and enhance the production of erythropoietin (EPO), thereby promoting red blood cell generation. Furthermore, SGLT2i enhance renal oxygenation by regulating the expression of hypoxia⁃inducible factor (HIF)⁃1α and HIF⁃2α, while also facilitating erythropoiesis through the optimization of iron metabolism. Moreover, SGLT2i may compensate for renal insufficiency by stimulating hepatic EPO production. Through these multifaceted mechanisms, SGLT2i ameliorate anemia and offer novel therapeutic insights for the treatment of renal anemia.

Key words: sodium?glucose cotransporter 2 inhibitors, anemia, erythropoietin, hypoxia?inducible factor, iron metabolism