Objective — to determine the effects of drug therapy with inclusion of sodium‑glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin on the blood levels of copeptin as a biomarker of renal and vascular lesions in patients with diabetic nephropathy (DN) at various disease stages.
 Materials and methods. Examinations involved 83 in‑hospital patients with DN, treated in the clinic of L. T. Mala National Institute of Therapy. Patients were divided into 2 groups depending on the therapy. 42 patients received a standard course of treatment, including antidiabetic drugs, renin‑angiotensin‑aldosterone system blockers and statins. In addition to standard therapy, the remaining 41 patients were administered SGLT2 inhibitor dapagliflozin in a dose of 10 mg per day. Patients were re‑examined after 6 months treatment. Determination of the copeptin level in blood serum was carried out by the enzyme immunoassay method using the set of reagents Human CPP Elisa Kit manufactured by FineTest, China.
 Results. The results of investigation of the effects of complex nephroprotective therapy on the lipid profile indicators in patients with type 2 diabetes mellitus (DM2) demonstrated significant decrease in the levels of total cholesterol by 11.78% (р <0.05), triglycerides by 19.75% (р <0.05) and non‑significant increase of high‑density lipoproteins by 5.10%. In patients with DM2 and with glomerular filtration rate (GFR) >90 mL/(min · 1.73 m2) (I stage chronic kidney disease (CKD)) the level of copeptin after treatment decreased by 19.3% (p <0.05); in patients with (DM2) and GFR of 60—89 mL/(min · 1.73 m2) (CKD II stage) — by 18.9% (p <0.05), and with GFR of 45—59 mL/(min · 1.73 m2) (CKD III stage) — by 24.8% (p <0.05). The significant decrease of copeptin levels was revealed in diabetic patients with both preserved and reduced GFR. In DM2 patients with normal GFR, the copeptin level after standard treatment decreased by 17.6% (p <0.05), and in case of dapagliflozin administration by 20.6% (p <0.05). In patients with reduced GFR, blood serum copeptin levels decreased by 18.9% (p <0.05) after standard therapy, and by 22.1% (p <0.05) under the influence of dapagliflozin.
 Conclusions. Complex therapy with the use of SGLT2 inhibitor dapagliflozin contributed to more significant reduction of copeptin levels in patients with DN compared to the standard treatment, regardless of the kidneys’ functional state. The decrease of copeptin levels against the background of the improved main clinical and laboratory parameters indicates not only an improvement in the kidneys’ functional state, but also reduction of cardiovascular risk in this group of patients.