Sodium-glucose cotransporter 2 inhibition in primary and secondary glomerulonephritis

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-pr...

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Detalles Bibliográficos
Autores: Caravaca-Fontán, F, Stevens, K, Padrón, M, Huerta, A, Montomoli, M, Villa, J, González, F, Vega, C, Mendoza, ML, Fernández, L, Shabaka, A, Rodríguez-Moreno, A, Martín-Gómez, A, Labrador, PJ, Andújar, AM, Soler, MCP, Martín-Penagos, L, Yerovi, E, Zahonero, LM, De La Flor, JC, Mon, C, Ibernon, M, Gómez, AR, Miquel, R, Sierra, M, Mascarós, V, Luzardo, L, Papasotiriou, M, Arroyo, D, Verdalles, U, Martínez-Miguel, P, Ramírez-Guerrero, G, Pampa-Saico, S, Berrio, EM, Canga, JLP, Tarragón, B, Gómez, PF, Regidor, D, Relea, J, Xipell, M, Gómez, CA, Navarro, M, Alvarez, A, Rivas, B, Quintana, LF, Gutiérrez, E, Pérez-Valdivia, MA, Odler, B, Kronbichler, A, Geddes, C, Anders, HJ, Floege, J, Fernández-Juárez, G, Praga, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16829
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/16829
Access Level:acceso abierto
Palabra clave:body mass index
estimated glomerular filtration rate
glomerular disease
proteinuria
sodium-glucose cotransporter 2 inhibitors
Descripción
Sumario: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.

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