{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:10:32Z","timestamp":1792181432155,"version":"4.4.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Backgroud<\/jats:title><jats:p>Recent trials suggest sodium-glucose cotransporter 2 inhibitors (SGLT2i) significantly reduced proteinuria in patients with IgA nephropathy (IgAN). While little was known its efficacy in clinical practice especially in those already received full dose reninangiotensin-aldosterone system (RAAS) inhibitors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 93 Chinese patients with biopsy-proven IgAN and persistent proteinuria underwent full supportive therapy, including optimal blood pressure control and full dose angiotensin-converting enzyme\u2013inhibitor or angiotensin receptor blocker therapy. Proteinuria reduction at three and six months after initiating SGLT2i therapy was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 93 patients were enrolled in this study and 62 of them completed the six-month follow-up. After SGLT2i administration, a significant reduction in proteinuria was observed, with a decrease of 22.9% (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) at three months and 27.1% (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) at six months. During the six-month follow-up period, a decline of 3.0\u2009mL\/min\/1.73m<jats:sup>2<\/jats:sup> in estimated glomerular filtration rate (eGFR) (<jats:italic>p<\/jats:italic>\u2009=\u20090.012) and an increase of 0.8\u2009g\/L in albumin (<jats:italic>p<\/jats:italic>\u2009=\u20090.017) were observed. The anti-hypertensive effect of SGLT2i was not significant (<jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090.05). Notably, a consistent antiproteinuric effect of SGLT2i was observed across various settings, including different age groups, baseline levels of proteinuria\/eGFR, use of immunosuppressive agents, and the presence of comorbid diabetes and hypertension (all <jats:italic>p<\/jats:italic> values &amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The proteinuria was significantly reduced after SGLT2i administration in IgAN patients with full dose angiotensin-converting enzyme\u2013inhibitor or angiotensin receptor blocker therapy. Importantly, the antiproteinuric effect of SGLT2i was observed independently of immunosuppressive agent therapy, age, baseline eGFR and proteinuria levels, as well as the history of hypertension and diabetes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1242241","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T12:59:36Z","timestamp":1694005176000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Effect of SGLT2 inhibitors on the proteinuria reduction in patients with IgA nephropathy"],"prefix":"10.3389","volume":"10","author":[{"given":"Yaping","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sufang","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xujie","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jicheng","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1016\/j.kint.2021.05.015","article-title":"Executive summary of the KDIGO 2021 guideline for the management of glomerular diseases","volume":"100","author":"Rovin","year":"2021","journal-title":"Kidney Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1001\/jama.2017.9362","article-title":"Effect of oral methylprednisolone on clinical outcomes in patients with IgA nephropathy: the TESTING randomized clinical trial","volume":"318","author":"Lv","year":"2017","journal-title":"JAMA"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3177","DOI":"10.1681\/ASN.2007050526","article-title":"Remission of proteinuria improves prognosis in IgA nephropathy","volume":"18","author":"Reich","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1056\/NEJMoa1515920","article-title":"Empagliflozin and progression of kidney disease in type 2 diabetes","volume":"375","author":"Wanner","year":"2016","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/S2213-8587(19)30180-9","article-title":"Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE\u2013TIMI 58 randomised trial","volume":"7","author":"Mosenzon","year":"2019","journal-title":"Lancet Diabetes endocrinol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1681\/ASN.2016030278","article-title":"Canagliflozin slows progression of renal function decline independently of glycemic effects","volume":"28","author":"Heerspink","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1056\/NEJMoa1811744","article-title":"Canagliflozin and renal outcomes in type 2 diabetes and nephropathy","volume":"380","author":"Perkovic","year":"2019","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.2337\/dc21-0300","article-title":"Efficacy and safety of dapagliflozin by baseline glycemic status: a prespecified analysis from the DAPA-CKD trial","volume":"44","author":"Persson","year":"2021","journal-title":"Diabetes Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.kint.2021.03.033","article-title":"A pre-specified analysis of the DAPA-CKD trial demonstrates the effects of dapagliflozin on major adverse kidney events in patients with IgA nephropathy","volume":"100","author":"Wheeler","year":"2021","journal-title":"Kidney Int"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2021.05.021","article-title":"2021 clinical practice guideline for the Management of Glomerular Diseases","volume":"100","year":"2021","journal-title":"Kidney Int"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/j.kint.2017.02.003","article-title":"\u201cOxford classification of IgA nephropathy 2016: an update from the IgA nephropathy classification working group,\u201d (in eng)","volume":"91","author":"Trimarchi","year":"2017","journal-title":"Kidney Int"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2925","DOI":"10.1681\/asn.2020050723","article-title":"Early change in albuminuria with Canagliflozin predicts kidney and cardiovascular outcomes: a PostHoc analysis from the CREDENCE trial","volume":"31","author":"Oshima","year":"2020","journal-title":"J Am. Society of Nephrol: JASN"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1111\/dom.14779","article-title":"Mechanisms of action of the sodium-glucose cotransporter-2 (SGLT2) inhibitor canagliflozin on tubular inflammation and damage: a post hoc mediation analysis of the CANVAS trial","volume":"24","author":"Sen","year":"2022","journal-title":"Diabetes Obes Metab"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1016\/s2213-8587(21)00243-6","article-title":"Effect of dapagliflozin on urinary albumin excretion in patients with chronic kidney disease with and without type 2 diabetes: a prespecified analysis from the DAPA-CKD trial","volume":"9","author":"Jongs","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/s2213-8587(20)30162-5","article-title":"Effects of the SGLT2 inhibitor dapagliflozin on proteinuria in non-diabetic patients with chronic kidney disease (DIAMOND): a randomised, double-blind, crossover trial","volume":"8","author":"Cherney","year":"2020","journal-title":"Lancet Diabetes Endocrinol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1242241\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T12:59:39Z","timestamp":1694005179000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1242241\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,6]]},"references-count":16,"alternative-id":["10.3389\/fmed.2023.1242241"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1242241","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,6]]},"article-number":"1242241"}}