HIỆU QUẢ CỦA DAPAGLIFLOZIN TRONG VIỆC CẢI THIỆN VI ALBUMIN NIỆU QUA CHỈ SỐ UACR: BÁO CÁO MỘT TRƯỜNG HỢP LÂM SÀNG

Abstract

Microalbuminuria is one of the earliest biomarkers of kidney damage and serves as an important prognostic indicator for the progression of chronic kidney disease (CKD) as well as cardiovascular events. In patients with type2 diabetes mellitus, the presence of microalbuminuria reflects renal microvascular injury and is closely associated with glycemic control, blood pressure regulation, and other cardiovascular risk factors. According to recommendations from endocrine and nephrology societies, the urinary albumin-to-creatinine ratio (uACR) is an effective screening and monitoring tool for the early detection and progression assessment of renal damage. In recent years, sodium-glucose co-transporter 2 inhibitors (SGLT2i), including Dapagliflozin, have demonstrated a prominent role in renoprotection in addition to their effects on glycemic control and cardiovascular benefits. The proposed mechanisms of SGLT2i involve reducing intraglomerular hypertension, decreasing sodium reabsorption in the proximal tubules, and improving endothelial function. Several large-scale clinical trials, such as DECLARE-TIMI 58 and DAPA-CKD, have shown that Dapagliflozin slows CKD progression and reduces albuminuria across various patient populations. In this article, we report the case of a 65-year-old male patient with a history of hypertension and type 2 diabetes mellitus, whose initial uACR was 2,284.3 mg/g. The patient was administered Dapagliflozin 10 mg daily. After two months of treatment, the uACR decreased significantly to 329.6 mg/g. Based on this clinical case and treatment outcome, we discuss the role of Dapagliflozin in substantially reducing the urinary albumin-to-creatinine ratio.