MO655PROTEINURIA DECREASE AFTER SGLT2I : WHAT CAN WE EXPECT?

Abstract

Abstract Background and Aims The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in reducing proteinuria secondary to type II diabetic nephropathy is well known. However, in daily practice we might have the impression that those patients who present with a higher proteinuria at the beginning of SGLT2i treatment might not reach an equal decrease of proteinuria compared to those with lower initial proteinuria (under 1g/24h). To verify this hypothesis we analysed the evolution of our patients depending on the initial proteinuria. Method A retrospective analysis of 40 patients who had initiated treatment with SGLT2i was carried out. At the beginning of treatment, 23 patients presented proteinuria over 1 gram/24h and the other 17 presented less than 1g/24h. The decrease of proteinuria after 6 months of follow-up was analysed in each group. The variations in serum creatinine, haemoglobin and glycosylated haemoglobin were also examined. A second analysis depending on initial glomerular filtration rate (Under and over 60 ml/min) was also performed. Results In table 1 the basal characteristics of this population are shown. Analysis of the complete population showed a significant decrease of proteinuria (Initial mean proteinuria was 1636+/-1513 mg/24h vs final mean proteinuria of 1320+/-1480mg/24h, p=0.015). Furthermore, the analysis by groups depending on initial proteinuria revealed that both groups had a significant reduction of proteinuria after 6 months: A second exam depending on initial GFR was carried out, proving that those with lower initial GFR maintained a significant decreased of proteinuria after 6 months of treatment. Conclusion In our cohort, against our hypothesis, we didn´t observe lower reduction of proteinuria when we started the treatment with proteinuria above 1 g/24h. We can consider that the effect of SGLT2i doesn’t decreased in patients with higher initial proteinuria. Therefore, we should always consider and offer this therapeutic option to our ND patients.