Kidney Week

Abstract: SA-PO0850

Proteinuria Reduction with SGLT2 Inhibitor Therapy for Lupus Nephritis: A Systematic Review and Single-Arm Meta-Analysis

Session Information

• Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
  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

• Soto Sanchez, Alfredo Hiram, Hospital Poliplaza Medica, Ciudad Juarez, Chih., Mexico

Alfredo Hiram Soto Sanchez, MD

• Arslan, Felemez, Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi, Istanbul, Turkey

Felemez Arslan, MD

• Duque, Juan, University of Miami Miller School of Medicine, Miami, Florida, United States

Juan Duque, MD

• Toh, Zhi Hui, University of Dundee, Dundee, Scotland, United Kingdom

Zhi Hui Toh

• Reynoso de la Torre, Hugo Leonardo, Centro Medico Nacional del Occidente, Guadalajara, Jal., Mexico

Hugo Leonardo Reynoso de la Torre, MD

• Moreira Lopes, Lucca, The University of Kansas Medical Center, Kansas City, Kansas, United States

Lucca Moreira Lopes, MD, MPH

• Marson, Bernardo Pavinato, Associacao Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

Bernardo Pavinato Marson, MD, PhD

• Oluyombo, Rotimi, Norfolk and Norwich University Hospital, Norwich, England, United Kingdom

Rotimi Oluyombo, MBChB, MSc

• Abrantes, Gabriel Wiese, Universidade Federal do Rio de Janeiro Instituto de Doencas do Torax, Rio de Janeiro, RJ, Brazil

Gabriel Wiese Abrantes

Background

Sodium–glucose cotransporter-2 inhibitors (SGLT2i) have shown potential renoprotective effects in lupus nephritis (LN). However, current evidence remains limited to small observational studies. We conducted a systematic review and single-arm meta-analysis to evaluate the effect of SGLT2i on renal outcomes in patients with LN.

Methods

PubMed, Embase, and Cochrane databases were systematically searched. Eligible studies included patients with LN treated with SGLT2i, reporting renal outcomes before and after treatment. Primary outcomes were changes in proteinuria and estimated glomerular filtration rate (eGFR). Pooled mean differences (MD) with 95% confidence intervals (CI) were calculated using random-effects models in R (version 4.5.2).

Results

Three observational studies comprising 91 patients with LN were included. Patients were predominantly female (87%) and non-diabetic (91%), with Class II–V LN. All patients received concomitant immunosuppressive therapy and had persistent residual proteinuria despite standard-of-care treatment. Mean baseline proteinuria and eGFR were 1,592 mg/24 h and 88 mL/min/1.73 m2. SGLT2i therapy was associated with a significant reduction in proteinuria (MD: −554 mg/24 h; 95% CI: −1,093.88 to −14.11; p=0.04) with low heterogeneity (I2=30.7%). No significant change in eGFR was observed (MD: 0.50 mL/min/1.73 m2; 95% CI: −8.31 to 9.31; p=0.91), suggesting preserved kidney function during follow-up.

Conclusion

SGLT2i may reduce proteinuria while preserving kidney function in patients with lupus nephritis. These findings suggest a potential adjunctive renoprotective role for SGLT2i in LN. However, current evidence is limited to small uncontrolled studies and may be confounded by concomitant immunosuppressive therapy. Larger controlled studies are needed to confirm these findings.

Figure 1. Mean difference in proteinuria after treatment (MD: −554 mg/24 h; 95% CI: −1093.88 to −14.11; p=0.04).

Figure 2. Mean difference in eGFR after treatment (MD: 0.50 mL/min/1.73 m2; 95% CI: −8.31 to 9.31; p=0.91).