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SGLT2 Inhibitors Decrease Overhydration and Proteasuria in Patients with Chronic Kidney Disease: A Longitudinal

Anja Schork1,2,3, Marie-Luise Eberbach1, Bernhard N Bohnert1,2,3

  • 1Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.

Kidney & Blood Pressure Research
|January 16, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors effectively reduce overhydration in chronic kidney disease (CKD) patients. This effect is more pronounced with higher levels of albuminuria and glucosuria.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiorenal Medicine

Background:

  • Chronic kidney disease (CKD) is frequently associated with extracellular volume expansion and overhydration (OH).
  • SGLT2 inhibitors are established treatments for reducing CKD progression and have demonstrated effects on extracellular volume in type 2 diabetes patients.

Purpose of the Study:

  • To investigate the efficacy of SGLT2 inhibitors in correcting overhydration (OH) in patients with chronic kidney disease (CKD).

Main Methods:

  • Prospective observational study of CKD patients over 6 months following initiation of SGLT2 inhibitor therapy.
  • Body composition and fluid status assessed using bioimpedance spectroscopy.
  • Urinary analysis included albuminuria, glucosuria, and protease activity.

Main Results:

  • SGLT2 inhibitors significantly reduced OH by 0.5 L/1.73 m2 after 6 months in CKD patients.
  • The reduction in OH correlated with baseline OH levels, decreased albuminuria, glucosuria, and urinary protease activity.
  • No significant reduction in adipose tissue mass was observed.

Conclusions:

  • SGLT2 inhibitors are effective in reducing overhydration (OH) in patients with CKD.
  • The beneficial effect on OH is more pronounced in patients with high albuminuria, glucosuria, and specific urinary protease activity.
Keywords:
Bioimpedance spectroscopyBody compositionChronic kidney diseaseOverhydrationProteasuriaSGLT2 inhibitor

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