Published: 8 June 2026
Author(s): Pedro Marques, Francisco Vasques-Nóvoa, Mariana Pintalhão, Rui Bergantim, Luís Mendonça, João Sérgio Neves, Fernando Friões, Abhinav Sharma, Gerassimos Filipatos, Javed Butler, Stefan Anker, Faiez Zannad, Milton Packer, João Pedro Ferreira
Issue: July 2026
Section: Original Article

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) increase hemoglobin and hematocrit, effects that have emerged as key statistical mediators of the cardiorenal benefits observed with SGLT2i therapies [1,2]. The underlying mechanisms of SGLT2i-induced erythrocytosis include enhanced iron mobilization and utilization, driven by upregulation of the erythropoietin-erythroferrone-transferrin receptor protein 1 (TfR1) axis [3]. Interestingly, data from observational studies and randomized clinical trials (RCTs) indicate that these hematologic effects occur independently of baseline anemia status [4–6].

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