Kidney Week

Abstract: TH-PO0456

Real-World Nephroprotective Effects of Dapagliflozin in IgAN: A Single-Center Experience

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - IgAN
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Annese, Francesca, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Francesca Annese, MD

• Di Leo, Vincenzo, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Vincenzo Di Leo, MD

• Papadia, Federica, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Federica Papadia, DrMed, MEd

• Ferrulli, Roberta, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Roberta Ferrulli, DrMed

• Cristello, Erika, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Erika Cristello, MD

• Rampino, Sabrina, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Sabrina Rampino

• Montinaro, Adriano, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Adriano Montinaro, MD

• Giliberti, Marica, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Marica Giliberti, MD

• Russo, Ilario, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Ilario Russo

• Giannuzzi, Francesca, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Francesca Giannuzzi, MS, MSc

• Sallustio, Fabio, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Fabio Sallustio, PhD

• Fiorentino, Marco, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Marco Fiorentino, MD, PhD

• Rossini, Michele, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Michele Rossini

• Gesualdo, Loreto, Nephrology, Dialysis and Transplantation Division, Department of Regenerative and Precision Medicine and Jonian Area – DiMePReJ, University of Bari “Aldo Moro”, Bari, Italy

Loreto Gesualdo, MD

Background

IgA Nephropathy (IgAN) is the most common primary glomerulonephritis worldwide and remains a leading cause of chronic kidney disease progression. Although SGLT2 inhibitors (SGLT2i) have demonstrated nephroprotective benefits in randomized trials, real-world evidence in IgAN is still limited.

Methods

We retrospectively evaluated adult patients with biopsy-proven IgAN treated with dapagliflozin 10 mg/day in addition to optimized supportive therapy (T1). Eligible patients had an eGFR >25 mL/min/1.73 m² and no recent exposure to immunosuppressive therapy. The primary outcome was the comparison of annual eGFR slopes before and after dapagliflozin initiation (T2). Secondary outcomes included changes in 24-hour proteinuria, hemoglobin levels and the relationship between BMI and post-treatment eGFR slope.

Results

Sixty-two patients were included (67.7% male, mean age 50.3 years). Following dapagliflozin initiation, the annual decline in kidney function showed a favorable attenuation, with mean eGFR slope improving from −3.12 ± 4.27 to −1.15 ± 5.62 mL/min/1.73 m²/year (Δ +1.97; p=0.072). Proteinuria response was highly heterogeneous, with no significant reduction observed after treatment initiation. Notably, the nephroprotective effect appeared independent of body weight, as no significant association emerged between BMI and post-treatment eGFR slope (Spearman r = −0.12, p = 0.34). In addition, hemoglobin levels significantly increased after dapagliflozin treatment (14.06 to 14.80 g/dL, p < 0.001).

Conclusion

In this real-world cohort of patients with IgAN, dapagliflozin was associated with a clinically meaningful trend toward slower kidney function decline. The renal benefit was independent of BMI, while the marked variability in proteinuria response suggests the need for further studies to identify predictors of therapeutic response. The observed rise in hemoglobin levels may represent an additional marker to monitor during follow-up.