Methods: Six pediatric patients who received SGLT2 inhibitors for more than 18 months were analyzed.The underlying diseases were vesicoureteral reflux (n = 2), renal hypoplasia (n = 2), familial juvenile hyperuricemic nephropathy (n = 1), and Alport syndrome (n = 1).The median age at initiation was 16.0 years.The annual change in estimated glomerular filtration rate (eGFR) during the two years before treatment was compared with that observed after six months of SGLT2 inhibitor therapy.Results: The mean baseline eGFR was 39.0 mL/min/1.73m 2 (range: 21.7-72.6).The mean eGFR during the two years prior to treatment was -3.37 mL/min/1.73m 2 /year (range: -9.66 to -2.18).During the first six months of therapy, eGFR worsened in five cases; however, from six months onward, the mean eGFR improved to -1.82 mL/min/1.73m 2 /year (range: -2.95 to 2.02), with improvement observed in all but one case.The median rate of change was +66.1 % (range: -24.4 to 192.4 %), and three patients demonstrated an upward trend in eGFR.Adverse events included one case of urinary tract infection and mild hypoglycemic symptoms in two cases.The five patients showing eGFR improvement had non-glomerular congenital renal diseases or CAKUT with negative or mild proteinuria.Conclusion: Our findings suggest that SGLT2 inhibitors can exert renoprotective effects even in pediatric CKD patients with minimal proteinuria.Because SGLT2 inhibitors are known to cause an initial transient decline in GFR ("initial dip") after therapy initiation, eGFR was evaluated from six months onward, beyond this phase, and improvement was observed in five of the six cases.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.
Olatise et al. (Wed,) studied this question.
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