Kidney Week

Abstract: FR-PO899

Efficacy and Safety of Dapagliflozin in the Treatment of Adult Primary IgA Nephropathy: A Single-Center, Prospective, Open, Randomized Controlled Study

Session Information

• IgA Nephropathy: Clinical, Outcomes, and Therapeutics
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Fei, Xiao, Department of Rheumatology and Clinical Immunology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China

Xiao Fei, RD

• Ling, Wang, Department of Rheumatology and Clinical Immunology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China

Wang Ling, MD

• Zi, Dai Huan, Department of Rheumatology and Clinical Immunology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China

Dai Huan Zi, PhD

Background

Despite optimized renin-angiotensin-aldosterone system ( RAAS ) inhibition, 20 % ~ 40 % of immunoglobulin A nephropathy (IgAN) patients will progress to end-stage renal disease within 10 ~ 20 years after diagnosis. We evaluated the efficacy and safety of dapagliflozin, when added to the treatment regimen of patients with IgAN.

Methods

Participants had IgAN proven by kidney biopsy(proteinuria with protein excretion of 0.3-3.5 g/d , serum albumin ＞ 30g/L and estimated glomerular filtration rate（eGFR)） > 30 mL/min/1.73 m² ) and were receiving optimized RAAS inhibitor therapy. Patients were randomly assigned 1:1 to receive daily oral dapagliflozin or not for 6 months.The primary outcome was percentage change in 24-hour urine protein excretion(24HUPE), first-morning urine albumin-creatinine ratio (UACR) between baseline and 6 months.

Results

60 participants (mean eGFR, 83.17 mL/min/1.73 m2; median 24HUPE 0.77 g/d; median UACR 636mg/g.Cr) were recruited and randomly assigned to receive dapagliflozin(n = 30) or not (n = 30). Percentage change in 24HUPE at 6 months was significantly different between the dapagliflozin group and the control group (45.8% [inter quartile range (IQR), 65.2%, 4.2%] vs 10.1% [IQR, −46.1%, 53.1%]; P < 0.05, respectively). At 6 months, median 24HUPE level was significantly lower in the dapagliflozin group than control group (0.35 [IQR, 0.18, 0.75] g/d vs 0.62 [IQR, 0.37, 1.21] g/d; P < 0.05, respectively). The change trend of UACR was the same as that of 24HUPE. No serious adverse events were recorded during the study in either study group.

Conclusion

Dapagliflozin in addition to optimized RAAS inhibition significantly reduced proteinuria in patients with IgAN over 6 months without evidence of adverse events.These findings require confirmation in larger treatment trials.

Funding

• Government Support – Non-U.S.