Abstract
Introduction: Diabetic kidney disease (DKD) is one of the leading causes of chronic kidney failure. Sodium-glucose cotransporter-2 (SGLT2) inhibitors indicated marked renoprotective effects, but their mechanisms and benefits remain unclear.
Objectives: The objective of this study is to assess initial changes in kidney functional and tubular injury biomarkers following the consumption of the SGLT2 inhibitor in DKD patients.
Materials and Methods: This study was designed as a prospective cohort conducted at Al-Basrah Teaching hospital in Basrah, Iraq, from January to December 2025. Patients with DKD were included and classified into two groups according to their treatment regimen; those with a stable antidiabetic treatment including an SGLT2 inhibitor and those with similar regimens without SGLT2 inhibitors. The samples from blood and urine were collected to measure standard kidney functional tests, including blood urea nitrogen (BUN), creatinine, and estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), and tubular injury biomarkers such as kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). The data were compared between two groups.
Results: Results demonstrated that 60 DKD patients with a mean age of 53.28 ± 8.08 years were included. Patients who received SGLT2 inhibitors had a better renal profile, with better conventional kidney function measurements (BUN, creatinine, and eGFR), lower albumin-to-creatinine ratio (UACR), and consistently reduced levels of tubular injury markers, including urinary KIM-1 and NGAL, in comparison to those who do not receive these agents, and these differences were statistically significant (P < 0.05).
Conclusion: Our study found, SGLT2 inhibitor therapy was accompanied by improvements in kidney functional tests and lower levels of tubular injury markers in DKD patients. These findings suggest that SGLT2 inhibitors may begin to confer renoprotective effects, particularly at the level of the renal tubules, supporting their use as an important component of care in this high-risk population.