Effect of Sodium Glucose Co Transporter 2 Inhibitor on Proteinuria In Diabetic Patients

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antidiabetic agents which lower blood glucose levels mainly by reducing glucose reabsorption in the renal proximal tubule, leading to an increase in urinary glucose and sodium excretion. As a result of increased glycosuria and natriuresis, the beneficial effects of SGLT2 inhibitors extend beyond glycemic control to reducing intraglomerular hypertension, promoting plasma volume contraction, lowering blood pressure , reducing body weight, and decreasing uric acid levels.. Given their intrarenal and extrarenal effects, SGLT2 inhibitors have been suggested to confer renoprotection in patients with type 2 diabetes.SGLT2 inhibitors may be more useful for type 2 diabetic patients at high risk of CKD progression (i.e., with albuminuria or a history of documented eGFR loss) because they appear to have large beneficial effects on CKD incidence. The aim of our study was to evaluate the effect sodium–glucose cotransporter-2 inhibitor (SGLT2) on proteinuria in diabetic patients and to compare it with the effect of classic antiproteinuric drugs. The studied population was divided into 2 groups that had no significant differences in their demographic data, laboratory investigations or eGFR. Placebo group included 30 patients whom were prescribed the classic antiproteinuric drugs in the form of ACE inhibitors or ARBs with aspirin and statins and Dapagliflozin group included 30 patients whom were prescribed the same treatment regimen as placebo group with adding on dapagliflozin 10 mg /day. Follow up of the patients was done after 6 months of treatment as regard changes in UACR , HbA1C , Blood pressure , body weight and eGFR.