MO1034: Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Alport Syndrome and Fsgs: A Case Series
Abstract
Most hereditary diseases of the glomerular filtration barrier still progress to end-stage renal failure (ESRF)—raising the urgent need for add-on therapies. Recent randomized clinical trials (RCTs) demonstrated the nephroprotective effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in chronic kidney diseases (CKD). SGLT2-mediated afferent arteriole vasoconstriction, additive to efferent arteriole vasodilatation by angiotensin-converting enzyme inhibitors (ACEis), is postulated to correct the haemodynamic overload of the glomerular filtration barrier. For that reason, we investigated the nephroprotective effect of SGLT2i in hereditary glomerular diseases.
In 2020, this monocentric prospective case series was started in six patients with Alport syndrome or FSGS, who consented to off-label therapy with empagliflozin or dapagliflozin. To our knowledge, this is the first case series on the effect of SGLT2i in patients with hereditary causes of CKD.
We report data on the use of SGLT2i in a case series of patients with Alport syndrome and FSGS in respect of the early effect on the kidney function and safety of initiation of therapy. The follow-up was 3–11 months. The mean age was 40 years (standard deviation, SD ± 17), the mean duration of treatment was 4.5 months (SD ± 2.9). The mean serum creatinine before and after SGLT2i initiation was 1.46 (SD ± 0.42) and 1.58 (SD ± 0.55). The mean urinary albumin-creatinine ratio in mg/g creatinine before SGLT2i was 1827 (SD ± 1560)…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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