SGLT2 inhibitors and their role in reducing adiposopathy and inflammation in diabetes and non-diabetes CKD patients.

AIMS: This study aims to evaluate differences in adiposopathy and specific inflammatory biomarkers between type 2 diabetes mellitus (T2DM) and non-T2DM patients across various stages of chronic kidney disease (CKD). In addition, it explores potential pathways through which sodium-glucose cotransporter 2 inhibitors (SGLT2i) impact renal outcomes via adipose tissue.

MATERIALS AND

METHODS

An observational prospective study was conducted on 143 CKD patients divided into 2 groups: SGLT2i cohort (n = 31) and standard-of-care (SoC) cohort (n = 112). Clinical and analytical data were collected upon recruitment (T0) as well as after 8 months of follow-up (T8).

RESULTS

At T0, patients under the SGLT2i group showed higher significance for cardiovascular upload versus those in SoC treatment, as well as higher values across several inflammation parameters (IL-6, TNF-α, ferritin). At T8, renal function improved in the SGLT2i group in relation to the SoC, accompanied by a decrease in most inflammatory and adiposopathy biomarkers, mainly leptin. Notably, dapagliflozin use (n = 20) was associated with significantly reduced leptin levels and stabilization of TNF-α concentrations vs. SoC at T8.

CONCLUSION

SGLT2i treatment, and particularly dapagliflozin, modulates both adiposopathy and systemic inflammation while slowing down renal function loss, demonstrating benefits for CKD patients regardless of diabetes status.