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Abstract: SA-PO891

Relationship Between Initial eGFR Dip and Changes in Laboratory Parameters With Dapagliflozin Treatment in Non-Diabetic CKD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Kokubu, Maiko, Department of Nephrology, Nara prefecture General Medical Center, NARA, NARA, Japan
  • Yamane, Masatomo, Department of Nephrology, Nara prefecture General Medical Center, NARA, NARA, Japan
  • Kitamura, Shunsuke, Department of Nephrology, Nara prefecture General Medical Center, NARA, NARA, Japan
  • Tansho, Kosuke, Department of Nephrology, Nara prefecture General Medical Center, NARA, NARA, Japan
  • Matsui, Masaru, Department of Nephrology, Nara prefecture General Medical Center, NARA, NARA, Japan
Background

Treatment with sodium-glucose co-transporter-2 inhibitors (SGLT2i) induces an initial decline in estimated glomerular filtration rate, also termed the ‘eGFR dip’ and remains beneficial effects for cardiovascular and kidney outcomes, even after modified by eGFR dip in diabetic CKD. However, the difference of eGFR dip after SGLT2i between diabetic and non-diabetic CKD patients and the effects of eGFR dip on changes of laboratory parameters is not fully understood. In this study, we aimed to investigate the eGFR dip after Dapagliflozin and its relationship with clinical and laboratory data in non-diabetic CKD patients.

Methods

We conducted a cohort study on 127 non-diabetic CKD patients receiving Dapagliflozin in whom at least two measurements of eGFR levels at three months were confirmed. eGFR dip was defined by percent eGFR change from baseline. eGFR was calculated using Japanese equation. Correlation analyses between initial eGFR dip and clinical value were conducted using the Pearson correlation coefficient.

Results

The mean age of study participants was 60±13 years and 69 (54%) were male. The underlying kidney diseases included glomerulonephritis in 59 (46%) patients and hypertensive nephrosclerosis in 57 (45%). The mean levels of baseline eGFR were 43±13 mL/min/1.73m2 and the mean proteinuria was 0.58±0.83 g/gCre. The mean eGFR change from baseline was -0.33±4.3 mL/min/1.73m2 with eGFR dip of 0.8±9.4%. Factors including age, sex, body mass index, baseline eGFR and urinary protein were not significantly associated with the eGFR dip. Dapagliflozin increased hemoglobin levels by 0.5g/dL and decreased uric acid levels by 0.9 mg/dL. We found indirect and direct correlation of the eGFR dip with changes in proteinuria (r=0.30,p=0.001) and uric acid levels (r=0.21,p=0.015) after Dapagliflozin, respectively.

Conclusion

Our results suggest that the eGFR dip following SGLT2i initiation may be associated with the changes of proteinuria and uric acid levels in non-diabetic CKD patients.