ESPN 53rd Annual Meeting

ESPN 2021

SGLT2i as renoprotection tool in children with CKD
Dmytro Ivanov 1 Mariia Ivanova 1


SGLT2i in adults with CKD have shown impressive results in reducing total and cardiovascular mortality and reducing the rate of progression of CKD. The clinical model for imitating the intake of SGLT2i in children is renal glucosuria, which does not bring significant suffering to the kids.

The aim of the study was to evaluate the safety and efficacy of SGLT2i  in children with CKD.

Materials and methods A prospective randomized, open out of label 6-month study was conducted in 9 children (8-17 years old) with CKD presented by isolated urinary syndrome in the form of albuminuria 244 12.5. All children have been already receiving an ACE inhibitor or ARB to control albuminuria. The following criteria for assessing the safety of SGLT2i were selected: assessment of the childs clinical condition, blood pressure, decrease in eGFR, development of urinary tract infections. Evaluation of the effectiveness of prescribing the drug was carried out according to the dynamics of albuminuria. The drug of choice is dapagliflozin, a dose of 0.125 mg / kg in one dose.

Results and discussion. Dapagliflozin has been shown to be well tolerated. Clinical complaints in the form of transient weakness were documented in 2 children (22%), a decrease in blood pressure by 5-10 percentiles in 3 (33%), a transient decrease in eGFR by 3±1 ml / min in 5 children (55%), no urinary tract infections in a single child. Efficiency in reducing albuminuria was demonstrated in 7 children (77%). Side effects of the drug were not sufficient as well as temporally. At the same time, the addition of SGLT2i to ACE inhibitor / ARB therapy reduced albuminuria from 243 ± 12 mg / L to 160 ± 9 mg / L (P0/01).

Conclusions. The preliminary results of the observations allow to consider the promising using SGLT2i in children with further determination of strict indications.