SGLT2 Inhibitor and GLP-1 Receptor Agonist Combination Therapy Substantially Improved the Renal Function in a Patient with Type 2 Diabetes: Implications for Additive Renoprotective Effects of the Two Drug Classes

Kenta Nonomura; Katsumi Iizuka; Yayoi Kuwabara-Ohmura; Daisuke Yabe

doi:10.2169/internalmedicine.4323-19

CASE REPORTS

SGLT2 Inhibitor and GLP-1 Receptor Agonist Combination Therapy Substantially Improved the Renal Function in a Patient with Type 2 Diabetes: Implications for Additive Renoprotective Effects of the Two Drug Classes

Kenta Nonomura, Katsumi Iizuka, Yayoi Kuwabara-Ohmura, Daisuke Yabe

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Keywords: diabetic kidney disease, estimated glomerular filtration rate, type 2 diabetes mellitus, GLP-1 receptor agonist, SGLT2 inhibitor

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 12 Pages 1535-1539

DOI https://doi.org/10.2169/internalmedicine.4323-19

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Abstract

A 72-year-old man had type 2 diabetes (T2D) that had been diagnosed at 54 years old. Macroalbuminuria was first detected at age 64. While his HbA1c had been kept below 7%, his estimated glomerular filtration rate (eGFR) was declining rapidly. At 70 years old, his eGFR dropped below 50 mL/min/1.73 m². A renal biopsy revealed diabetic nephropathy. Sodium glucose transporter 2 inhibitors (SGLT2i)/glucagon-like peptide-1 receptor agonists (GLP-1RA) combination therapy substantially improved his eGFR and urinary albumin level, and the renoprotective effect persisted for the two-year study period. These findings suggest that SGLT2i and GLP-1RA can additively improve the renal function in patients with T2D.

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