Real-World Experience With Dapagliflozin in Non-diabetic Chronic Kidney Disease: A Case Series From India

Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2is), including dapagliflozin, have demonstrated reno-protective effects independent of glycemic control in chronic kidney disease (CKD). The data presented here add to the already available evidence on the use of dapagliflozin in patients with non-diabetic kidney disease Methods: Non-diabetic CKD patients treated with dapagliflozin at a tertiary care center in India were included in the case series. Data for parameters, including renal function (estimated glomerular filtration rate (eGFR) and serum creatinine), proteinuria, and metabolic parameters, were retrieved retrospectively. Results: Data of six non-diabetic patients with glomerular disorders (five with IgA nephropathy, one with membranous nephropathy) treated at a tertiary care center were collected. An initial decline in eGFR was observed at two weeks post-initiation of dapagliflozin, followed by significant recovery at six months (Day 14: 38.83 ± 9.21 ml/min/1.73 m² vs. Day 180: 44.83 ± 9.78 ml/min/1.73 m²; P = 0.0052). Proteinuria demonstrated progressive reduction across a six-month duration. Lipid profile analysis indicated a reduction in triglycerides but no significant changes in total cholesterol. No adverse events were reported. Conclusion: Dapagliflozin was well tolerated and associated with improvements in renal function and proteinuria in non-diabetic CKD patients with autoimmune glomerular disorders. These findings support the advantages of dapagliflozin treatment in reducing the progression of CKD in non-diabetic patients.