Efficacy of Dapagliflozin and Telmisartan Combination Therapy in Reducing Albuminuria and Inflammatory Markers in Diabetic Nephropathy: A Prospective Observational Study.

BACKGROUND: Diabetic nephropathy, a major contributor to chronic kidney disease, is closely associated with inflammatory responses.

OBJECTIVES: This study aimed to evaluate the effectiveness of combination therapy with dapagliflozin and telmisartan in treating diabetic nephropathy and its effect on patient's albuminuria levels.

MATERIALS AND METHODS: We conducted a 12-week prospective observational study to assess diabetic nephropathy. Patients with diabetic nephropathy were treated with either dapagliflozin and telmisartan (n=92) or telmisartan alone (n=92). Measurements of waist-to-hip ratio, fasting blood glucose, hemoglobin A1c (HbA1c), blood pressure, urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), uric acid, blood urea nitrogen, lipid profile, and inflammatory biomarkers, including C-C motif chemokine ligand 21 messenger RNA (CCL21 mRNA) and monocyte chemoattractant protein-1 (MCP-1), were obtained at baseline and following 12-weeks of treatment.

RESULTS: Dapagliflozin and telmisartan combination therapy demonstrated a significant decrease in UACR compared with baseline levels (p<0.001). After treatment, the dapagliflozin and telmisartan group had significantly lower waist-to-hip ratio, fasting blood glucose, HbA1c, uric acid, total cholesterol, and low-density lipoprotein compared with the monotherapy group (p<0.05). Additionally, inflammatory biomarkers, including CCL21 mRNA and MCP-1, were substantially lower in the combination therapy group than in the monotherapy group (p<0.05).

CONCLUSION: In comparison to monotherapy, combination therapy demonstrated more significant clinical effects in treating diabetic nephropathy. This combination therapy effectively controls blood glucose levels and UACR, reduces inflammatory responses, and improves kidney function recovery in diabetic nephropathy patients, thereby enhancing the overall clinical treatment outcomes for these patients.