Effect of SGLT2 Inhibitors on Renal Resistive Index in Diabetic Nephropathy Patients: A Quasi-experimental Study

Introduction: Diabetic Nephropathy (DN) is a frequent and severe complication of Type 2 Diabetes Mellitus (T2DM) that often progresses to End-Stage Renal Disease (ESRD). Renal Resistive Index (RI) and Urine Albumin-to-Creatinine Ratio (UACR) are valuable indicators used to evaluate renal microvascular health and DN progression. Doppler ultrasonography of the renal arteries is a non invasive tool for analysing renal blood flow, with RI providing insight into vascular resistance by comparing systolic and diastolic flow velocities. Aim: To assess the impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on RI in T2DM patients. Materials and Methods: A quasi-experimental study involving 148 participants, categorised into normoalbuminuric and microalbuminuric groups, was conducted at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India. Patients received SGLT2 inhibitors for three months, after which RI and UACR were reassessed. Paired t-tests were used to compare pre- and postintervention values within groups, while independent t-tests and Chi-square tests were applied to compare baseline characteristics and outcomes between groups. A p-value <0.05 was considered statistically significant. Results: Post-treatment findings showed significant reductions in RI and UACR values, indicating improved renal haemodynamics and reinforcing the renal protective role of SGLT2 inhibitors (p-value <0.001). Conclusion: These results underscore the therapeutic relevance of SGLT2 inhibitors in preserving renal microcirculation and delaying DN progression.