Abstract: SA-PO0812
Antiproteinuric Effect of SGLT2 Inhibitors in Nondiabetic Glomerulopathies Is Dependent on Body Mass Index
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
- Vargas-Brochero, Maria J., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Russo, Ilario, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Mazzierli, Tommaso, Nephrology and Dialysis Firenze, Florence, Italy
- Cara, Anila, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Berti, Gian Marco, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Milheiro, Joaquim, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Allinovi, Marco, Nephrology and Dialysis, Careggi University Hospital, Florence, Italy
- Somma, Chiara, Nephrology and Dialysis Firenze, Florence, Italy
- Raglianti, Valentina, Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- D'Arpino, Emanuele, University of Florence, Florence, Italy
- Zand, Ladan, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Nunez-Delgado, Sara, Hospital del Vall d'Hebron, Barcelona, Spain
- Soler, Maria Jose, Hospital del Vall d'Hebron, Barcelona, Spain
- Sethi, Sanjeev, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Gutierrez-Martinez, Eduardo, Hospital Universitario 12 de Octubre, Madrid, Spain
- Praga, Manuel, Hospital Universitario 12 de Octubre, Madrid, Spain
- Caravaca-Fontan, Fernando, Hospital Universitario 12 de Octubre, Madrid, Spain
- Romagnani, Paola, Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Fervenza, Fernando C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are emerging as an essential part of the standard of care for proteinuria in patients with chronic kidney disease. Here we report the impact of BMI on the antiproteinuric efficacy of SGLT2i in non-diabetic patients with glomerulopathies.
Methods
Retrospective, multicenter, international observational cohort study that included non-diabetic patients with biopsy-proven glomerular disease and proteinuria more than 0.5 g/24h who received SGLT-2i between 2016 and 2023. Laboratory values, including proteinuria and estimated glomerular filtration rate (eGFR), were obtained at baseline and after 6 months. Changes in laboratory over time were analyzed with paired signed-rank test
Results
300 patients met the inclusion criteria. Median age 51.82 [41, 62.65] years; 64.7% male, and most common glomerular disease was IgA nephropathy (40.3%). Median eGFR 52.26 [36.4, 74.0] ml/min/1.73 m2, proteinuria 1.6[1.15, 2.91] g/24hr, and serum albumin 4.08 [3.8, 4.3] g/dl. Proteinuria reduction after SGLT2i initiation was significant only in overweight and obese patients (Figure 1). Patients with normal BMI did not experience the expected early drop in eGFR.
Conclusion
SGLT-2i are ineffective in proteinuria reduction in patients with BMI<25 kg/m2, which contrasts with the significant proteinuria reduction in overweight and obese patients with glomerulopathies
Figure 1: Box plots with the differences between baseline and 6 months in a) proteinuria, and b) eGFR according to the BMI groups.