Kidney Week

Abstract: SA-PO0634

Effect of the SGLT2 Inhibitor Dapagliflozin on Kidney Hemodynamics in Patients with IgAN

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - Other
  October 24, 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

• Hiramatsu, Miya, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Miya Hiramatsu, MD

• Kato, Sawako, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Sawako Kato, MD, PhD

• Nakamura, Yoshihiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Yoshihiro Nakamura, MD

• Maeda, Kayaho, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Kayaho Maeda, MD

• Kosugi, Tomoki, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Tomoki Kosugi, MD, PhD

• Maruyama, Shoichi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Shoichi Maruyama, MD, PhD

Background

Immunoglobulin A (IgA) nephropathy is a common form of glomerulonephritis. Despite standard therapy including immunosuppressants, progression to kidney failure is still not uncommon. It is established that sodium-glucose cotransporter 2 inhibitors (SGLT2i) exert renoprotective effect in participants with chronic kidney disease with and without type 2 diabetes, including those with IgA nephropathy. We evaluated change in renal hemodynamics after SGLT2i administration in patients with IgA nephropathy receiving conservative treatment after remission induction.

Methods

The RH-Red study was approved as an observational study by the ethics committee of Nagoya University Graduate School of Medicine (No. 2023-0079). We directly measured GFR (mGFR) and effective renal plasma flow (eRPF) using inulin and para-aminohippuric acid clearance at baseline and 6 months after initiation of SGLT2i administraion. We also assessed glomerular filtration fraction (FF), renal blood flow (RBF) and renal vascular resistance (RVR).

Results

A total of 31 patients were enrolled. The mean age was 47 years, 42% were male, and 81% were receiving ACEi/ARB. Mean baseline eGFRcr, albuminuria, and blood pressure were 70 mL/min/1.73 m², 319 mg/gCr, and 122/78 mmHg, respectively. Compared with baseline, mGFR and FF were significantly reduced after 6 months of SGLT2i treatment, with mean changes of −8.3 mL/min (95% CI, −11.9 to −4.9; P < 0.0001) and −0.03 (95% CI, −0.05 to −0.02; P = 0.0004), respectively, as assessed by paired t-tests. No significant changes were observed in eRPF, RBF, or RVR. Figure shows the individual measured values.

Conclusion

This study demonstrated that SGLT2i reduced FF in patients with IgA nephropathy. These findings suggest that one of the renoprotective mechanisms of SGLT2i might be the amelioration of glomerular hyperfiltration, plausibly resulting in reduced intraglomerular pressure.

Figure