Dapagliflozin was prescribed for children aged < 19 years with kidney disease and proteinuria despite taking an angiotensin-converting-enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), with an eGFR of ≥ 20 ml/min/1.73 m 2 at baseline between July 2022 and December 2023. Clinicians adjusted the dose based on body weight and eGFR, but there was no standardized protocol. All eligible patients who consented received dapagliflozin during this period. Children treated with dapagliflozin for > 3 months were reviewed in this study. None of the children had any of the following pre-existing conditions: polycystic kidney disease, type 1 diabetes, uncontrolled urinary tract infections, kidney transplantation, current cancer diagnosis, and evidence of liver disease. Proteinuria was defined as a spot urine protein/creatinine ratio (uPCR) of ≥ 0.2 mg/mg. The term "eGFR dipping" refers to the immediate reduction in eGFR instantly after starting the dapagliflozin treatment. Decreased proteinuria was defined as a uPCR lower than the initial treatment level at the last visit, and glycosuria as the presence of glucose 4 + in a patient's spot urine stick test at the 1-month visit. This retrospective study was approved by the Seoul National University Hospital institutional review board (IRB no. 2304-049-1421).
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Dapagliflozin for Pediatric Kidney Disease
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Corresponding Organization :
Other organizations : Korea University Medical Center, Seoul National University, Ajou University, Seoul National University Children's Hospital, Chungnam National University, Ajou University Hospital
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Variable analysis
independent variables
- Dapagliflozin treatment
- Immediate reduction in eGFR (eGFR dipping)
- Decreased proteinuria
- Presence of glycosuria
- Children aged < 19 years with kidney disease and proteinuria despite taking an ACEi or ARB
- EGFR of ≥ 20 ml/min/1.73 m2 at baseline
- No polycystic kidney disease, type 1 diabetes, uncontrolled urinary tract infections, kidney transplantation, current cancer diagnosis, or evidence of liver disease
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