Investigation of the effect of SGLT-2 inhibitor use on urinary angiotensinogen level in diabetic chronic kidney disease

Background and aim: The relationship between diabetic nephropathy and RAS has been demonstrated by important studies and it has been observed that RAS activation leads to progressive nephron loss. In this study, we planned to investigate the effect of newly started SGLT-2 inhibitors on urine AGT (angiotensinogen) levels in patients with chronic kidney disease and diabetes who had never used sodium-glucose co-transporter 2 (SGLT-2) inhibitors before. Materials and Methods: The study was conducted with 88 patients with diabetes and chronic kidney disease who had never used sodium-glucose co-transporter 2 (SGLT-2) inhibitor group drugs. A spot urine sample was taken from each patient. Urine samples separated from the spot urine sample were centrifuged. Samples were stored at -80 degrees. Urine AGT levels were measured by ELISA (Enzyme-Linked ImmunoSorbent Assay) method Findings: When we look at the 0th month and 6th month UAGT n/l and Urine AGT/Urine Creatinine Level (UAGT/ucre) mcg/g values, a significant decrease was observed (p=0,000 and p=0,000). When we compared the 0th and 6th month Hba1c values after SGLT-2 inhibitor use, we found a significant decrease, p<0.001. Conclusions: As a result of the combined use of RAS inhibitors and SGLT-2 inhibitors, an increase in glomerular filtration rate, effective glycemic control and blood pressure control are achieved. The combination of RAS inhibitors and SGLT-2 inhibitors is recommended in diabetic nephropathy. Keywords: Urinary angiotensinogen, renin angiotensin system, proteinuria, diabetes, chronic kidney disease