{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:06:49Z","timestamp":1790309209345,"version":"4.1.0"},"reference-count":39,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Haematol"],"abstract":"<jats:p>Introduction: Patients with homozygous \u03b2-thalassemia show continuously improved survival, which has contributed to the development of kidney complications, predominantly expressed as increased albuminuria. In particular, patients with transfusion-dependent thalassemia frequently develop chronic kidney complications related to chronic anemia, iron overload, and exposure to iron chelation therapy. Although sodium-glucose co-transporter 2 inhibitors have demonstrated renoprotective effects in patients with chronic kidney disease (CKD) from other causes, their efficacy in patients with homozygous \u03b2-thalassemia and established CKD remains unknown. Methods: In this prospective, open-label study, we investigated the impact of dapagliflozin (10 mg\/day), in patients with homozygous \u03b2-thalassemia and an albumin-to-creatinine ratio (ACR) &gt;30 mg\/g. Study end-points included the effect on ACR and kidney function at 6 months after treatment initiation. Furthermore, we examined the effect on systolic blood pressure (SBP) and diastolic blood pressure, and on urine monocyte chemoattractant protein-1 (MCP-1) and matrix metalloproteinase-9 (MMP-9) levels. Results: Twelve patients with ACR &gt;30 mg\/g received dapagliflozin, and 18 patients with normal ACR were followed up for 6 months. Twenty-three healthy adult individuals age- and sex-matched to the \u03b2-thalassemia group were used as normal controls. Patients with ACR &gt;30 mg\/g showed a significant reduction of ACR and SBP at 6 months (p = 0.034, p = 0.025, respectively), while kidney function remained stable. Patients with homozygous \u03b2-thalassemia showed increased baseline urine MCP-1 levels, while MMP-9 showed no differences versus normal controls. Those who received dapagliflozin exhibited a significant decrease in urine MCP-1 (p = 0.022), while MMP-9 remained stable. There were no significant adverse events. Conclusion: Dapagliflozin at a standard dose of 10 mg daily is safe and effectively reduces albuminuria and urinary MCP-1 in patients with homozygous \u03b2-thalassemia and established CKD, suggesting potential kidney anti-inflammatory effects. Further studies with larger cohorts and longer follow-up are needed to determine its impact on CKD progression and long-term outcomes.<\/jats:p>","DOI":"10.1159\/000552285","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:00:42Z","timestamp":1782489642000},"page":"1-10","source":"Crossref","is-referenced-by-count":1,"title":["Dapagliflozin in Patients with Homozygous \u03b2-Thalassemia and Albuminuria"],"prefix":"10.1159","author":[{"given":"Konstantinos","family":"Tsiotsios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8043-739X","authenticated-orcid":false,"given":"Sotirios 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