Peritoneal glucose uptake reduction by sodium-glucose co-transporter 2 inhibitors in clinical peritoneal dialysis

Introduction: In peritoneal dialysis (PD), managing peritoneal glucose uptake is a clinical challenge, as the uptake leads to peritoneal ultrafiltration loss. Peritoneal expression of sodium-glucose co-transporter 2 (SGLT2) suggests that SGLT2 inhibitors, a class of antidiabetic agents, may offer a solution. Methods: In 12 PD patients, we examined the influence of dapagliflozin, an SGLT2 inhibitor, on peritoneal equilibration test. Results: The volume of drainage and the total glucose content in drainage were larger in the test with dapagliflozin than in that without dapagliflozin (2.41 ± 0.16 vs. 2.23 ± 0.20 L, p = 0.011 and 16.9 ± 3.8 vs. 14.5 ± 3.7 g, p = 0.005, respectively). Conclusion: SGLT2 inhibitors could reduce peritoneal glucose uptake and improve fluid removal in clinical PD.