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Kidney Week

Abstract: PO1015

Correlation of Anti-Albuminuric Effect by SGLT2 Inhibitor with Tubulointerstitial Impairment

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Sato, Saeko, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Takayanagi, Kaori, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Shimizu, Taisuke, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Iwashita, Takatsugu, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Hara, Hiroaki, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Ogawa, Tomonari, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Hasegawa, Hajime, Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
Background

This study aimed to examine the anti-albuminuric effect of SGLT2 inhibitor (SGLT2i) in patients with or without renal dysfunction, and to investigate factors associated with the effect of SGLT2i.

Methods

Patients with diabetic nephropathy were enrolled and received 50 mg of Iplagliflozin. Their blood and urine were sampled at 0 M, 1 M and 12 M. Patients with renal dysfunction (DF; eGFR<60) and with normo-renal function (NF; eGFR≥60) were separately analyzed.

Results

In all patients (n=22), urine albumin-to-Cr ratio (ACR) was reduced at 1M and maintained until 12M (median: 236.2 at 0M, 115.0 mg/gCr at 1M), however, eGFR was not changed. In DF, ACR was also decreased (median: 311.8 at 0M vs 107.0 mg/gCr at 1M, n=10). In NF, ACR was similarly decreased at 1M. Next, the patients in DF and NF were divided by %ACR reduction (high responder: HR, low responder: LR). In NF, only %change of eGFR at 12M was significantly different (-6.5±8.6% in HR vs +5.0±7.6% in LR). In DF, MCP-1 at 1M (-33.0±7.3% in HR vs +45.9±33.1% in LR) and %change of NAG at 12M showed significant difference (-33.6±13.5% in HR vs +6.8±28.3% in LR), however, there was no difference in eGFR. Univariate analysis showed significant correlation between %ACR reduction and %MCP-1 at 1M (R=0.734, p=0.016) or %NAG at 12M (R=0.714, p=0.047) in DF whereas no significant correlation was observed in NF. Multivariate analysis confirmed the results.

Conclusion

In patients with normo-renal function, restoring glomerular hyperfiltration might be important for anti-albuminuric effect of SGLT2i. However, in patients with renal dysfunction, the effect of SGLT2i seemed to be associated with reduced tubulointerstitial damages.

Anti-albuminuric effect of SGLT2 inhibitor in patients with or without renal dysfunction