EVALUATION OF RENAL OUTCOMES IN IGA NEPHROPATHY PATIENTS IN THE NATIONAL KIDNEY AND TRANSPLANT INSTITUTE RECEIVING SGLT2 INHIBITOR TREATMENT VERSUS STANDARD OF CARE — A RETROSPECTIVE STUDY

 

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EVALUATION OF RENAL OUTCOMES IN IGA NEPHROPATHY PATIENTS IN THE NATIONAL KIDNEY AND TRANSPLANT INSTITUTE RECEIVING SGLT2 INHIBITOR TREATMENT VERSUS STANDARD OF CARE — A RETROSPECTIVE STUDY

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Willianne Roselle
Gutierrez
Willianne Roselle Gutierrez drwillgutierrez@gmail.com National Kidney and Transplant Institute Adult Nephrology Quezon City Philippines *
Anthony Rusell Villanueva villanueva.russ@gmail.com National Kidney and Transplant Institute Adult Nephrology Quezon City Philippines -
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IgA nephropathy (IgAN) is an inflammatory renal disorder marked by the  accumulation of IgA in the glomerular mesangium and is the most frequently documented primary  glomerulonephritis globally. The standard treatment  protocol for individuals with IgA nephropathy includes using supportive measures such as lifestyle  intervention, medications inhibiting renin-angiotensin-aldosterone system (RAAS), fish oil, with  or without any immunosuppressive agents like steroids, azathioprine, mycophenolate mofetil, cyclophosphamide, or rituximab. A study by Wheeler et al. provides initial evidence that sodium glucose cotransporter-2 inhibitors (SGLT2i) may be a safe and effective adjunct to the current line  of care in IgAN. This study aims to evaluate the renal outcomes of IgAN patients receiving SGLT2  Inhibitor versus patients receiving standard care from 2022 to 2024 and 2016 to 2018 respectively.

This study is a facility-based, retrospective chart review, involving 124 biopsy-diagnosed IgAN patients. Baseline demographics, laboratory parameters, clinical outcomes were compared. Wilcoxon Signed-rank test and McNemar–Bowker Test were used for the rank and frequency differences of patients’ laboratory parameters on each follow up. 


A total of 108 individuals with biopsy-confirmed IgA nephropathy were included, categorizing them into two groups: one receiving standard of care (SOC) and the other receiving SGLT2i treatment. The baseline serum creatinine levels and estimated GFR (eGFR) were compared between two groups, with the SGLT2i group showing slightly lower values. After 3 months, creatinine and eGFR levels improved, with SGLT2i users showing higher mean values. At 6 months, renal function stabilized, with a median creatinine level of 1.18 mg/dL, an eGFR of 74.78 mL/min/1.73 m2, and a UPCR of 0.95. After 12 months, the median creatinine level remained constant, while eGFR values were higher in the SGLT2i group. Longitudinal comparisons showed a considerable improvement in UPCR and urine dipstick protein, with no significant long-term changes detected. 


The study found that SGLT2 inhibitor therapy improved renal outcomes in patients with IgA nephropathy. During a 12 month follow-up period, SGLT2 inhibitors maintained renal function stability and reduced urine dipstick proteinuria and urine protein creatinine ratio. Standard treatment led to higher progression to renal replacement therapy. SGLT2 inhibitors combined with standard therapy and supportive care, provide enhanced kidney protection in IgA nephropathy. 


Kewords