#6929 sglt2 inhibitors in iga nephropathy: real life experience at our centre

Abstract Background and Aims SGLT2 inhibitors (SGLT2i) have a beneficial effect in diabetic and non-diabetic proteinuric chronic kidney disease (CKD), demonstrated in large randomized controlled trials. However, there is limited information about real life experience with SGLT2i in non-diabetic CKD like IgA nephropathy (IgAN). Method All patients with biopsy-proven IgA nephropathy since 2015 were evaluated for SGLT2i use. We collected data on age, gender, the use of renin-angiotension-aldosterone system inhibitors (RAASi), eGFR, glycosuria and proteinuria at baseline, at 6 months and at one year of follow-up. Glomerular filtration rate (eGFR) was estimated using the CKD-EPI equation. Data was analyzed using Jamovi®. Results 51 patients had IgAN diagnosed by kidney biopsy from April 2015 until March 2021. Eleven of these started SGLT2i between December 2020 and February 2022 (at their physician's description). Their median age was 52, nine were male and all were taking RAASi. The initial median proteinuria was 1 g/g (range 0.5-2.0 g/g), median eGFR was 57.5 mL/min (range 16.8-104 mL/min). At 6 months, the median proteinuria was 0.7 g/g (range 0.8-4.8 g/g), median eGFR was 42.6 mL/min (range 13.9-108 mL/min). One year after beginning SGLT2i, 8 patients have laboratory values and the median value of proteinuria was 0.85 g/g (range 0.2-3.0 g/g) and the median eGFR was 40.5 mL/min (range 14.5-85.4 mL/min). All patients had glycosuria at all urine evaluations confirming no discontinuations of the SGLT2i. No serious adverse events were reported and none of the patients needed dialysis or died. There were no significant differences between proteinuria and eGFR between evaluations at the start, 6 months and 1 year of follow-up. Conclusion SGLT2i have become important drugs in IgAN. Our first cases who started SGLT2i showed good compliance (using glycosuria as an indirect tool to monitor adherence) and no adverse events, irrespective of their initial eGFR. The small sample was probably a limitation to the lack of significant results.