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Sodium-glucose cotransporter 2 inhibition in primary and secondary glomerulonephritis

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Autores de IDIVAL

  • Luis Martín Penagos

    Autor

Autores ajenos al IDIVAL

  • Caravaca-Fontán F
  • Stevens K
  • Padrón M
  • Huerta A
  • Montomoli M
  • Villa J
  • González F
  • Vega C
  • López Mendoza M
  • Fernández L
  • Shabaka A
  • Rodríguez-Moreno A
  • Martín-Gómez A
  • Labrador PJ
  • Molina Andújar A
  • Soler MCP
  • Yerovi E
  • Medina Zahonero L
  • De La Flor JC
  • Mon C
  • Ibernon M
  • Gómez AR
  • Miquel R
  • Sierra M
  • Mascarós V
  • Luzardo L
  • Papasotiriou M
  • Arroyo D
  • Verdalles Ú
  • Martínez-Miguel P
  • Ramírez-Guerrero G
  • Pampa-Saico S
  • Moral Berrio E
  • Canga JLP
  • Tarragón B
  • Gómez PF
  • Regidor D
  • Relea J
  • Xipell M
  • Gómez CA
  • Navarro M
  • Álvarez Á
  • Rivas B
  • Quintana LF
  • Gutiérrez E
  • Pérez-Valdivia MÁ
  • Odler B
  • Kronbichler A
  • Geddes C
  • Anders HJ
  • Floege J
  • Fernández-Juárez G
  • Praga M
  • Spanish Group for the Study of Glomerular Diseases (GLOSEN) and the Immunonephr

Unidades

Abstract

Background. The role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in the management glomerular/systemic autoimmune diseases with proteinuria in real-world clinical settings is unclear. Methods. This is a retrospective, observational, international cohort study. Adult patients with biopsy-proven glomerular diseases were included. The main outcome was the percentage reduction in 24-h proteinuria from SGLT2i initiation to 3, 6, 9 and 12 months. Secondary outcomes included percentage change in estimated glomerular filtration rate (eGFR), proteinuria reduction by type of disease and reduction of proteinuria >= 30% from SGLT2i initiation. Results. Four-hundred and ninety-three patients with a median age of 55 years and background therapy with renin-angiotensin system blockers were included. Proteinuria from baseline changed by -35%, -41%, -45% and -48% at 3, 6, 9 and 12 months after SGLT2i initiation, while eGFR changed by -6%, -3%, -8% and -10.5% at 3, 6, 9 and 12 months, respectively. Results were similar irrespective of the underlying disease. A correlation was found between body mass index (BMI) and percentage proteinuria reduction at last follow-up. By mixed-effects logistic regression model, serum albumin at SGLT2i initiation emerged as a predictor of >= 30% proteinuria reduction (odds ratio for albumin <3.5 g/dL, 0.53; 95% CI 0.30-0.91; P = .02). A slower eGFR decline was observed in patients achieving a >= 30% proteinuria reduction: -3.7 versus -5.3 mL/min/1.73 m2/year (P = .001). The overall tolerance to SGLT2i was good. Conclusions. The use of SGLT2i was associated with a significant reduction of proteinuria. This percentage change is greater in patients with higher BMI. Higher serum albumin at SGLT2i onset is associated with higher probability of achieving a >= 30% proteinuria reduction.

© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.

Datos de la publicación

ISSN/ISSNe:
0931-0509, 1460-2385

NEPHROLOGY DIALYSIS TRANSPLANTATION  OXFORD UNIV PRESS

Tipo:
Article
Páginas:
328-340
PubMed:
37550217

Citas Recibidas en Web of Science: 20

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Keywords

  • body mass index; estimated glomerular filtration rate; glomerular disease; proteinuria; sodium-glucose cotransporter 2 inhibitors

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