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Initial effect of sodium-glucose cotransporter-2 inhibitors on kidney function in patients with immunoglobulin A nephropathy

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This study aims to evaluate the early effects of sodium-glucose cotransporter-2 inhibitors on kidney function in patients with immunoglobulin A nephropathy receiving RAAS inhibitors.
Adult patients newly diagnosed with IgAN from 2020-2024 were selected.
Eligible criteria included eGFR ≥35 mL/min/1.73 m2 and UPCR ≥0.8 g/g, receiving RAAS inhibitors for ≥28 days.
Changes in eGFR, UPCR, and UACR at 12 months were analyzed using mixed-effect models.
SGLT2i use was associated with an early eGFR decline of -5.39 mL/min/1.73 m2 (95% CI, -9.51 to -1.26).
No significant reduction in UPCR (GMR, 0.90; 95% CI, 0.68-1.18) or UACR (GMR, 0.94; 95% CI, 0.67-1.34) was observed at 12 months.
Subgroup analyses indicated potential benefits for patients without segmental glomerulosclerosis or with elevated systolic blood pressure (≥130 mmHg).

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Randomized trial evaluates kidney function impact of SGLT2 inhibitors in IgAN, suggesting individual benefits.

Kim et al. (2026) studied this question.

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