Background and Aims: Nephrotic syndrome addressed as one of the most common causes of inherited chronic kidney disease. Where, protein is excessively filtered into the urine.Sodium-glucose cotransporter 2 (SGLT2) inhibitors in nephrotic patients on immunosuppression are underexplored.This research aimed to investigate the impacts of dapagloflozin in treatment of proteinuria in patients with nephrotic syndrome. Material and methods: A prospective clinical trial involving fifty-six adult patients, without a diagnosis of diabetes, with persistent proteinuria. Group A; 28 patients received traditional medicines; Group B; 28 patients received dapagloflozin; 10 mg daily. We determine the changes from baseline of urinary protein/creatine (Up/cr) and glomerular filtration rate (based on epi GFR formula). Results: Both groups exhibited significant reductions in proteinuria posttreatment, with dapagliflozin group achieving a mean UPCR reduction of -94.7%, and Group A -86.7% (p < 0.001). Posttreatment, FPG, 2hPG, and HbAlc levels in Group B were significantly lower than thosein Group A (P<0.05). Posttreatment, Scr, BUN, UmAlb, UAER, UACR, and 24-hour urine protein quantitative levels inGroup B were significantly lower than those in the control group (P<0.05). Posttreatment, hs-CRP, IL-1β, and TNFα levels in Group B were significantly lower than those in Group A (P<0.05). The incidence of adverse reactions in Group B significantly lower than Group A (P<0.05). Conclusion: Compared with enalapril maleate alone, the combined application of dapagliflozin in treatment of diabetic kidneydisease has more significant clinical efficacy. It can further controlpatients’ blood sugar, reduce their body’s inflammatory response,alleviate or eliminate their proteinuria symptoms, promote recovery of their renal function, and enhance safety of theirtreatment to a certain extent that helps to further improve clinical treatment effect.
