2652 ANTIPROTEINURIC EFFECT OF SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS IN GLOMERULAR AND SYSTEMIC DISEASES: A REAL-WORLD CLINICAL STUDY

Abstract Background and Aims Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have recently begun to be used in glomerular/systemic autoimmune diseases with glomerular involvement for the treatment of proteinuria, although the information on real-world clinical settings is very scarce. Method Retrospective, observational, international cohort study. Adult patients with biopsy-proven glomerular diseases were included. The main outcome was the percentage reduction in 24-hour proteinuria from SGLT2i initiation to 3, 6, 9, 12 months. Secondary outcomes included percentage proteinuria reduction by type of disease and a reduction of proteinuria ≥30% from SGLT2i initiation. Results The study group consisted of 493 patients with a median age of 55 years. All patients were on renin-angiotensin system blockade. Geometric mean percentage change of proteinuria from baseline was –35%, –41%, –45% and –48% at 3, 6, 9 and 12 months after SGLT2i initiation, respectively. Geometric mean percentage change of eGFR was –6%, –3%, –8%, –10.5% at 3, 6, 9 and 12 months, respectively. Results were similar irrespective of the underlying disease. However, a significant correlation was found between body mass index (BMI) and percentage proteinuria reduction at last follow-up (R = –0.11; p = 0.02). By mixed-effects binomial logistic regression model, serum albumin at the onset of SGLT2i emerged as the main predictor of a ≥30% proteinuria reduction (odds ratio for albumin