Abstract: SA-PO0863
SGLT2 Inhibitor (Empagliflozin) as Adjuvant Therapy for Nephrotic-Range Proteinuria: Study on Efficacy and Metabolic Benefits
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
- Park, Sihyung, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
- Heo, Changmin, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
- Park, Bongsoo, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
- Kim, Yang Wook, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
Background
SGLT2 inhibitors effectively reduce proteinuria and protect renal function, with recent literature highlighting their benefits in non-diabetic renal conditions beyond their initial use in diabetic kidney disease. This study aimed to clarify the additional benefits of SGLT2 inhibitors in patients with nephrotic range proteinuria (NRP).
Methods
Patients with NRP (≥ 3.5 g/day or ≥ 3 g/g) or nephrotic syndrome were enrolled and divided into two groups: prednisolone + empagliflozin 10 mg/day (PE group) and prednisolone alone (P group). Prednisolone was administered as needed for symptom management. The primary endpoint was metabolic changes, while secondary endpoints assessed 30% and 50% proteinuria reduction.
Results
Twenty-two patients were analyzed (PE: 12, P: 10). Underlying causes included IgA nephropathy, membranous nephropathy, focal segmental glomerular sclerosis, and lupus nephritis. There were no significant differences in delta creatinine and cystatin C levels at 12 weeks (p = 0.45). There were no significant differences in delta serum albumin (p = 0.4), However, serum albumin concentration at 12 weeks was significantly higher in the PE group (4.1 ± 0.4 vs. 3.5 ± 0.74 g/dL, p = 0.03). Delta HbA1C levels showed no significant differences (p = 0.21), although two new diabetes cases emerged in the prednisolone-only group.
Regarding proteinuria reduction, the PE group achieved an 83% rate of 30% proteinuria reduction at 4 weeks, significantly higher than the 40% in the P group (p = 0.03). Rates for a 50% reduction at 12 weeks were 83% in the PE group versus 70% in the P group, respectively (p = 0.45).
Conclusion
The inclusion of empagliflozin in combination with prednisolone demonstrated a positive effect in patients with steroid-treated glomerulonephritis, significantly enhancing early proteinuria reduction in NRP patients. While kidney function markers remained stable, combination therapy led to higher serum albumin levels. Furthermore, the absence of new diabetes cases in the combination group, contrasted with their presence in the monotherapy group, suggests potential metabolic benefits. These findings indicate that SGLT2 inhibitors offer significant additional advantages for patients with nephrotic range proteinuria.
Funding
- Commercial Support – Yuhan Corp