Abstract: SA-PO0823
Increasing SGLT2 Inhibitor Use in Glomerular Diseases
Session Information
- Glomerular Management: Real-World Lessons and Emerging Therapies
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Chiang, Melody, University of Michigan, Ann Arbor, Michigan, United States
- Smerdon, Caroline, University of Michigan, Ann Arbor, Michigan, United States
- Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States
- Modi, Zubin J., University of Michigan, Ann Arbor, Michigan, United States
- Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
Group or Team Name
- CureGN.
Background
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve renal and cardiovascular outcomes in patients with type 2 diabetes, chronic kidney disease, and immunoglobulin A nephropathy (IgAN), yet prescribing rates remain low. Little is known about trends in SGLT2i use in patients with glomerular disease.
Methods
We used data from the Cure Glomerulopathy (CureGN) Consortium, an NIH-sponsored multicenter prospective observational cohort study of patients with biopsy-proven diagnosis of glomerular disease. A generalized estimating equation logistic model was fit for any SGLT2i use in a calendar year. Predictors included demographic (age, sex, insurance, education level, rural versus urban residency, biopsy location) and clinical characteristics (eGFR, UPCR, comorbidities, medication use).
Results
We identified 1,632 adults with at least one CureGN study visit from 2020-2024. The percent of participants with a SGLT2i prescription increased from 1.8% to 21.6% overall from 2020-2024 and from 2.7% to 36.5% among those with eGFR<=75. Participants were more likely to be on an SGLT2i in later study years (p<0.0001). Other factors significantly associated with SGLT2i's included higher UPCR (p<0.0001), lower eGFR (p<0.0001), overweight/obese status (p=0.02), and attainment of a college degree or higher (p=0.006). Those with minimal change disease (p<0.0001) or membranous nephropathy (p<0.0001) were less likely to have a SGLT2i prescription compared to those with IgAN.
Conclusion
SGLT2i use in glomerular disease is increasing but less than 25% of participants had a prescription in 2024. In concordance with clinical indications, patients with lower eGFR or greater UPCR were more likely to receive SGLT2i’s. Attainment of a college degree, as a proxy for health literacy or higher socioeconomic status, may improve a patient’s likelihood of receiving effective new therapies for glomerular disease. Targeted interventions addressing these factors may increase SGLT2i prescribing.
Funding
- NIDDK Support