TOPLINE:

At 8 months, patients with chronic kidney disease (CKD) who received SGLT2 inhibitors, particularly dapagliflozin, had significantly lower levels of leptin than those who received standard care.

METHODOLOGY:

• Researchers conducted a prospective study to compare effects of SGLT2 inhibitors vs standard care on renal function, adiposopathy, and inflammatory biomarkers in 143 patients with CKD stages G1-G4 who were not on dialysis, with or without type 2 diabetes.
• Participants were divided into two groups: those who received SGLT2 inhibitors (n = 31; median age, 70 years; 58.06% men) and those who received standard care (n = 112; median age, 65 years; 44.64% men); dapagliflozin was the most commonly administered SGLT2 inhibitors (64.52%).
• Clinical and laboratory data, including markers of adiposopathy (leptin) and inflammation (TNF-alpha [TNF-α], interleukin-6, C-reactive protein, and ferritin), were collected at baseline and after 8 months of follow-up.

TAKEAWAY:

• At 8 months, the SGLT2 inhibitor group had significantly lower levels of leptin than the standard care group (mean, 15.78 vs 29.71 ng/mL; P < .04); those receiving dapagliflozin had significantly lower levels of leptin than those receiving standard care (P < .021).
• At 8 months, the mean estimated glomerular filtration rate declined from 70.75 to 67.77 mL/min/1.73 m² in the standard care group, whereas the rate increased from 51.07 to 54.78 mL/min/1.73 m² in the dapagliflozin group, indicating better preservation of renal function.
• At baseline, mean TNF-α levels were significantly higher in the dapagliflozin group than in the standard care group (14.91 vs 8.44 pg/mL; P < .012), but after 8 months, these levels reduced — more so with dapagliflozin — becoming similar between the two groups (8.77 vs 7.97 pg/mL; P = .920).

IN PRACTICE:

"Treatment with SGLT2i [SGLT2 inhibitors] (specifically dapagliflozin) positively influences adiposopathy and inflammatory parameters, such as leptin, and TNF-α, with the known effect on reducing microalbuminuria with kidney function preservation," the authors wrote.

"Dapagliflozin's effects could improve adipose tissue dysfunction beyond the presence of obesity and/or T2DM [type 2 diabetes]," they added.

SOURCE:

This study was led by Checa-Ros Ana, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain. It was published online on December 17, 2025, in International Urology and Nephrology.

LIMITATIONS:

This study was limited by the small sample size in the SGLT2 inhibitor group, the short follow-up duration, and the lack of adipose tissue biopsies to confirm mechanistic insights.

DISCLOSURES:

This study was funded by the Generalitat Valenciana (Ayudas a Grupos Emergentes). The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.