Investigation of the effects of dapaglyflozin on kidney functions in patients with diabetic nephropathy

OBJECTIVE: In the study, patients who were diagnosed with diabetes mellitus and were treated with SGLT-2 treatments (dapagliflozin) and received oral antidiabetic therapy from patients with stage 0, hypertrophic nephropathy, stage 1, stage 2 and stage 3 according to the diabetic nephropathy stages according to the GFR (glomerular filtration rate) value divided into two groups and it was aimed to analyze the changes in the kidney functions of these patients through some variables that are routinely checked in the follow-ups at 0 and 6 months. MATERIALS AND METHODS: The research is a retroprospectively planned study and the data were obtained from the existing records of the patients who applied to the Malatya İnönü University Faculty of Medicine Endocrinology outpatient clinic between January 2018 and December 2021. 94 patients who met the inclusion criteria and used dapagliflozin or other oral antidiabetic drug groups (determined as the control group) were included in the study. Renal function tests such as GFR, creatinine, MTP/Cre ratio (protein/creatinine ratio), MTP (protein), BUN (blood urea nitrogen), uric acid, and Hba1c, c-peptide, lipid panel, glucose in full urinalysis, leukocyte, erythrocyte and protein status at 0 and 6 months were compared. Analyzes were made with the SPSS 22.0 program. RESULTS: 50.0% of the patients included in the study were male and 50.0% were female, with a mean age of 59,28±9,12. %56,4 of the patients included in the study use dapagliflozin, 43.6% use oral antidiabetic drugs other than SGLT-2 inhibitors. In the patient group using dapagliflozin, the mean GFR at 6 months (91.72±14.96) was found to be statistically significantly higher than the mean GFR at 0 months (87.64±14.79). It was determined that there was no significant change in the control patient group. There was no statistically significant difference between the mean of MTP/Cre and LDL at 0 and 6 months in dapagliflozin and control patient groups. CONCLUSION: In the patient groups included in the study, it was determined that the average GFR of those using dapagliflozin increased over time, and the HbA1c and triglyceride values decreased. It was observed that the median of SPOT MTP and SPOT creatinine values in the patient group using dapagliflozin decreased at 6 months, while there was no significant change in the control group. It was determined that the mean GFR values of those using dapagliflozin in the patient groups at the 0th month were significantly higher than the patients in the control group, and the GFR continued to be elevated in the patient groups at the 6th month.