Dapagliflozin Reduced Proteinuria in Kidney Case Report
A recent case report detailed significant improvements in a patient with nephrotic-range proteinuria after starting treatment.
Updated on Sept. 21, 2026 in Diabetes
A case report published online August 31, 2026, described a patient with secondary collapsing focal segmental glomerulosclerosis who achieved a decline in proteinuria levels after beginning dapagliflozin. By day 1300 of the treatment timeline, the patient's proteinuria had fallen to less than 1.0 g/g Cr.
Why it matters
This case highlights the potential for dapagliflozin to manage nephrotic-range proteinuria in complex patients with underlying kidney injury and multiple comorbidities. Further research is necessary to determine if these findings can be replicated in larger, controlled cohorts.
A patient with collapsing lesions in 42% of glomeruli experienced a decline in proteinuria from 4.8 g/g Cr to under 1.0 g/g Cr following dapagliflozin therapy. The patient's estimated glomerular filtration rate remained stable throughout the study period.
The players
Dapagliflozin
This medication is a sodium-glucose cotransporter 2 inhibitor used to manage type 2 diabetes and chronic kidney disease.
The details
The patient presented with idiopathic pulmonary fibrosis and chronic kidney disease, later developing nintedanib-associated glomerular injury. Following the withdrawal of nintedanib and initial management with esaxerenone, dapagliflozin was introduced to address persistent, high-level proteinuria.
Timeline
Day 606: The patient developed leg edema and 3+ proteinuria.
Day 753: Treatment with esaxerenone was initiated.
Day 844: Dapagliflozin treatment was initiated.
Day 1300: Proteinuria levels declined to less than 1.0 g/g Cr.
August 31, 2026: The case report was published online.
The Big Picture
This case study follows the clinical pattern set by the DAPA-CKD trial by assessing SGLT2 inhibitor efficacy in patients with chronic kidney disease. It extends existing evidence by exploring the medication's impact on secondary collapsing focal segmental glomerulosclerosis.
Patients with complex kidney conditions should consult their nephrologist regarding potential off-label or emerging treatments like dapagliflozin. Decisions regarding medication adjustments should be managed by specialized medical professionals to monitor for side effects and efficacy.
The takeaway
Clinicians may consider dapagliflozin as a potential therapeutic intervention for patients struggling with persistent proteinuria. This case underscores the importance of personalized treatment plans in managing complex renal injuries.
Further reading
For more information on similar conditions, visit the Diabetes section.
