Abstract: FR-PO0493
Dapagliflozin Reduces KIM-1 in Nondiabetic Individuals with Obesity and Insulin Resistance: A Randomized, Double-Blind, Crossover Trial
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Pretel, Flávia Hosana de Macedo, Universidade Federal de Sao Paulo Escola Paulista de Medicina, São Paulo, SP, Brazil
- Favaro, Leandro, Universidade Federal de Sao Paulo Escola Paulista de Medicina, São Paulo, SP, Brazil
- Quinto, Beata M r, Universidade Federal de Sao Paulo Escola Paulista de Medicina, São Paulo, SP, Brazil
- Marrocos, Mauro Sergio Martins, Universidade Federal de Sao Paulo Escola Paulista de Medicina, São Paulo, SP, Brazil
- Batista, Marcelo Costa, Universidade Federal de Sao Paulo Escola Paulista de Medicina, São Paulo, SP, Brazil
Background
Visceral obesity and insulin resistance are associated with hemodynamic and inflammatory alterations that may precede kidney injury even in the absence of diabetes or albuminuria. Glomerular hyperfiltration mediated by hyperinsulinemia and increased sodium–glucose cotransporter-2 (SGLT2) activity is considered a key mechanism in this process. Kidney Injury Molecule-1 (KIM-1) may enable early detection of tubular injury. However, evidence regarding SGLT2 inhibitors in obese non-diabetic individuals with preserved renal function remains limited.
Methods
We conducted a prospective, randomized, double-blind, placebo-controlled crossover trial at a single center involving 62 participants. Obese adults (BMI ≥30 kg/m2) without diabetes, albuminuria, or reduced kidney function (eGFR ≥60 mL/min/1.73m2) were stratified according to insulin resistance status using the HOMA-IR index. Metabolic parameters, renal injury biomarkers, inflammatory markers, and body composition were evaluated before and after dapagliflozin treatment.
Results
Among participants with insulin resistance, dapagliflozin significantly increased hemoglobin and hematocrit levels, reduced fasting glucose, and produced a modest increase in serum creatinine. KIM-1 levels decreased significantly, with an approximate 63% reduction after treatment. In contrast, participants without insulin resistance showed no significant changes in most evaluated parameters. No significant differences were observed in body composition in either group.
Conclusion
Dapagliflozin reduced circulating KIM-1 levels in obese non-diabetic individuals with preserved kidney function and insulin resistance, suggesting a potential early protective effect against proximal tubular injury before the onset of overt chronic kidney disease or albuminuria.
Funding
- Government Support – Non-U.S.