Abstract: FR-OR089

Effect of SGLT-2 Inhibitors to Proximal Tubular Function and Injury in Patients with Type 2 Diabetes: A Randomized Controlled Trial

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Korkiatpitak, Pattharamon, Phramongkutklao hospital, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao hospital, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao hospital, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao Hospital, Pathumthani, Thailand
  • Tasanavipas, Pamila, Phramongkutklao Hospital, Pathumthani, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao hospital, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao Hospital, Pathumthani, Thailand

Group or Team Name

  • phramongkutklao
Background

Intensive glucose control reduces the risk for microvascular complications in type 2 diabetes (T2DM). Recently, sodium glucose cotransporter 2 (SGLT2) inhibitors have the potential to exert renoprotection beyond glycemic control, the effects of SGLT2 inhibitors on the organs are not well known. There is limited data of SGLT2 inhibitors on biomarkers of kidney injury in T2DM patients.

Methods

T2DM patients with persistent HbA1c > 7% randomly assigned to add dapagliflozin 10 mg/day or standard treatment for 12 weeks. Proximal tubular injury biomarkers including urine kidney injury molecule-1 (KIM-1), urine cystatin-C, urine albumin to creatinine ratio (UACR), fraction excretion of phosphate (FEPO4) and uric acid (FEUric) were measured at baseline and the end of study.

Results

Patients were randomized to receive dapagliflozin (N=28) and control (N=29). Baseline characteristics were comparable across treatment groups. After 12 weeks, dapagliflozin-treated versus standard-treated patients showed reductions in HbA1c (-0.75 ± 0.21 vs -0.07 ± 0.25 %, p-value=0.882), fasting plasma glucose (-19.59 ± 8.26 vs -11.07 ± 8.71 mg/dL, p-value=0.481) and serum uric acid -0.06 ±0.18 vs 0.18 ± 0.12 mg/dL). There were significant between-group differences in the reduction of UACR (-23.31 ± 10 vs 19.88 ± 11.54 mcg/mgCr., p-value=0.010) and urine KIM-1 to creatinine ratio (-26.70 ± 98.2 vs 422.19 ± 181.05 mcg/mgCr, p-value=0.036), but no significant in changes of urine cystatin-C to creatinine ratio between two groups. There was no significant change of glomerular filtration rate, serum phosphorus, FEUric and FEPO4 in the dapagliflozin. No serious renal-related adverse events were observed in any group.

Conclusion

This study indicates that dapagliflozin in T2DM patients can decrease urinary proximal tubular injury biomarkers which refer to renoprotective effects. SGLT2-Inhibitors may be useful in treating T2DM for protect renal tubular injury and may lead to a reduced long-term renal outcome.

Funding

  • Other NIH Support