EFFECT OF SODIUM GLUCOSE CO TRANSPORTER 2 INHIBITOR ON PROTEINURIA IN DIABETIC PATIENTS

Abstract Background Diabetic kidney disease (DKD) is considered a major cause of end stage renal disease (ESRD). It has been established that controlling microalbuminuria can delay progression to ESRD. Sodium glucose co transporter 2 inhibitor (SGLT2 i) is a newer antidiabetic drug that has a renoprotective and antiproteinuric effect. Aim of the Study to study the effect of SGLT2 inhibitor on proteinuria in diabetic patients and compare it with classic antiproteinuric drugs. Patients and Methods we conducted a randomized interventional study, involving 60 adult patients with type 2 DM divided into 2 groups: group I were prescribed the classic antiproteinuric drugs in the form of ACE inhibitors or ARBs, aspirin and statins and group II were prescribed an additional dapagliflozin 10 mg/day. Follow up as regard changes in UACR, HbA1C, Blood pressure, body weight and e GFR was done after 6 months of treatment. Results There was statistically significant decline in UACR after 6 months of treatment with dapagliflozin in group II in comparison to group I (p-value < 0.001). There was also statistically significant decline in SBP in both groups with (p-value < 0.010) in group I and (p-value <0.001) in group II and there was significant decline in DBP in both groups (p-value < 0.001). HbA1c decreased significantly in both groups, (p-value <0.023) in group I and (p-value <0.001) in group II. We also noted a significant reduction of body weight in group II (p-value <0.001). There was a statistically significant negative correlation between the change in UACR and the change in e GFR. Conclusion There was better reduction in albuminuria when adding dapagliflozin to antiproteinuric drugs, so we recommend starting dapagliflozin early in patients with DKD to delay progreesion to ESRD.