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Biomedicines
Volume 13
Issue 6
10.3390/biomedicines13061303
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Dapagliflozin’s Effects on Urinary Albumin and Non-Albumin Proteins in Diabetic and Non-Diabetic Kidney Transplant Recipients

by
Giancarlo Bilancio
1,*,
Sarah Hamzeh
2,
Nicoletta Vecchione
2,
Dora Russo
2,
Candida Iacuzzo
3,
Luca Apicella
3,
Renata Angela Di Pietro
3,
Piercarla Vitale
1,
Maria Amicone
2,
Antonio Pisani
2,
Massimo Cirillo
1 and
Carmine Secondulfo
1
1
Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
2
Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy
3
Unit of Nephrology, Dialysis and Transplant, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(6), 1303; https://doi.org/10.3390/biomedicines13061303
Submission received: 16 April 2025 / Revised: 14 May 2025 / Accepted: 22 May 2025 / Published: 26 May 2025
(This article belongs to the Special Issue New Advances in Chronic Kidney Disease: Biology, Diagnosis and Therapy (2nd Edition))
Versions Notes

Abstract

Background: SGLT2 inhibitors (SGLT2is) lower glucose and have renoprotective effects, including reducing proteinuria. In kidney transplant recipients (KTRs), proteinuria impacts graft and patient survival. While SGLT2is benefits have been reported in diabetic KTRs, the data on non-diabetic KTRs are poor, and no data are available for albuminuria and non-albumin proteinuria. This study assessed the effects of dapagliflozin on urinary protein excretion in KTRs with and without diabetes. Methods: This analysis, from the Salerno CKD Cohort Study, included 66 KTRs (≥1 year post-transplant) with proteinuria despite renin–angiotensin system inhibitor therapy. The patients received dapagliflozin (10 mg/day) for six months, with assessments at the baseline (T0), three months (T1), and six months (T2); adverse events were monitored. The primary outcomes were changes in the urinary total, albumin, and non-albumin proteins. The secondary outcomes included weight, blood pressure, and eGFR. Results: At T1, the urinary total, albumin, and non-albumin proteins were significantly decreased, with a greater reduction in the non-albumin proteins vs. albumin (−27% vs. −9.4%, p = 0.001). No further changes occurred at T2. The patients’ weight and blood pressure also declined, while their eGFR and glucose remained stable. The non-albumin protein reduction was correlated with weight loss and diastolic blood pressure changes. Two patients discontinued use due to adverse events (one with a urinary tract infection, one with hypotension). Conclusion: Dapagliflozin reduces proteinuria, particularly non-albumin proteins, in KTRs with and without diabetes, with a low incidence of adverse effects. Further studies are needed to confirm the long-term benefits, especially in non-diabetic recipients.
Keywords: albuminuria; non-albumin proteinuria; kidney transplant; SGLT2is albuminuria; non-albumin proteinuria; kidney transplant; SGLT2is

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MDPI and ACS Style

Bilancio, G.; Hamzeh, S.; Vecchione, N.; Russo, D.; Iacuzzo, C.; Apicella, L.; Di Pietro, R.A.; Vitale, P.; Amicone, M.; Pisani, A.; et al. Dapagliflozin’s Effects on Urinary Albumin and Non-Albumin Proteins in Diabetic and Non-Diabetic Kidney Transplant Recipients. Biomedicines 2025, 13, 1303. https://doi.org/10.3390/biomedicines13061303

AMA Style

Bilancio G, Hamzeh S, Vecchione N, Russo D, Iacuzzo C, Apicella L, Di Pietro RA, Vitale P, Amicone M, Pisani A, et al. Dapagliflozin’s Effects on Urinary Albumin and Non-Albumin Proteins in Diabetic and Non-Diabetic Kidney Transplant Recipients. Biomedicines. 2025; 13(6):1303. https://doi.org/10.3390/biomedicines13061303

Chicago/Turabian Style

Bilancio, Giancarlo, Sarah Hamzeh, Nicoletta Vecchione, Dora Russo, Candida Iacuzzo, Luca Apicella, Renata Angela Di Pietro, Piercarla Vitale, Maria Amicone, Antonio Pisani, and et al. 2025. "Dapagliflozin’s Effects on Urinary Albumin and Non-Albumin Proteins in Diabetic and Non-Diabetic Kidney Transplant Recipients" Biomedicines 13, no. 6: 1303. https://doi.org/10.3390/biomedicines13061303

APA Style

Bilancio, G., Hamzeh, S., Vecchione, N., Russo, D., Iacuzzo, C., Apicella, L., Di Pietro, R. A., Vitale, P., Amicone, M., Pisani, A., Cirillo, M., & Secondulfo, C. (2025). Dapagliflozin’s Effects on Urinary Albumin and Non-Albumin Proteins in Diabetic and Non-Diabetic Kidney Transplant Recipients. Biomedicines, 13(6), 1303. https://doi.org/10.3390/biomedicines13061303

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