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Kidney Week

Abstract: TH-PO1126

Clinical Value of Adding Dapagliflozin in Patients with Nephrotic Syndrome

Session Information

  • Late-Breaking Posters
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • ElSharkawy, Magdy, Ain Shams University Faculty of Medicine, Cairo, Egypt
  • Teama, Nahla Mohamed, Ain Shams University Faculty of Medicine, Cairo, Egypt
  • Ahmed, Mohamed Mohyedin, Ain Shams University Faculty of Medicine, Cairo, Egypt
  • Emara, Ahmed, Ain Shams University Faculty of Medicine, Cairo, Egypt
Background

The potential utilization of SGLT2 inhibitors in glomerular disease patients undergoing immunosuppression therapy has remained underexplored. This study evaluates the clinical impact of dapagliflozin in non-diabetic primary nephrotic syndrome patients.

Methods

We conducted a randomized controlled clinical trial with 60 non-diabetic primary nephrotic syndrome patients, equally assigned to dapagliflozin and control groups. The dapagliflozin group received dapagliflozin 10 mg/day in addition to standard care, while the control group received standard care alone. Baseline characteristics, including age, gender, nephrotic syndrome etiology, proteinuria levels, estimated glomerular filtration rate (eGFR), and immunosuppression doses, were well-matched. Both groups were followed for 6 months. 1ry outcomes included changes in proteinuria (measured by urine PCR, UPCR) and eGFR. 2ry outcomes encompassed alterations in body weight and lipid profile changes. Pregnant or breastfeeding females and patients with secondary nephrotic syndrome were excluded.

Results

Both groups exhibited significant reductions in proteinuria after 6 months, with the dapagliflozin group achieving a mean UPCR reduction of -94.7%, and the control group -86.7% (p < 0.001). However, the comparative percentage change in proteinuria between both groups did not reach statistical significance (p = 0.158). Dapagliflozin initially led to a transient eGFR decline followed by recovery, while the control group maintained stable eGFR. Dapagliflozin also resulted in a significant mean body weight reduction of 3.91 kg (p < 0.001) and notable improvements in triglyceride levels compared to the control group (p = 0.045). Although no major safety concerns arose, the dapagliflozin group exhibited a slightly higher incidence of urinary tract infections.

Conclusion

In primary nephrotic syndrome patients, adjunct dapagliflozin may enhance the standard of care. While notable, the reduction in proteinuria was comparable to that of the control group by the study's end. Furthermore, after 6 months, eGFR remained stable in both groups. However, significant weight loss and serum triglyceride reduction were particularly pronounced in the dapagliflozin group. Further long-term investigations are necessary to address potential immunosuppression-related confounding effects in patients with primary glomerular disease.