Effect of Sodium-glucose Cotransporter-2 Inhibitors (SGLT-2i) on Proteinuria in Nephrotic Children Older Than 10 Years

Effect of Sodium-glucose Cotransporter-2 Inhibitors (SGLT-2i) on Proteinuria in Nephrotic Children Older Than 10 Years

The goal of this clinical trial is to evaluate the effect of ACE inhibitors and SGLT-2 inhibitors on:

1. Proteinuria
2. Renal survival indices

This is a randomized, double blind study. Patients are randomized to receive oral ACE inhibitors or combined ACEI and SGLT-2inhibitrs once daily for12 weeks.

Inclusion Criteria:

• Age between 10 and 18 years old,
• Nephrotic resistant patients,
• No history of diabetes,
• Estimated GFR≥60ml/min/1.73m2, will be evaluated by Schwartz formula,
• Caregivers' acceptance to be enrolled in the study.

Exclusion Criteria:

• Uncontrolled urinary tract infection at screening,
• Blood pressure is less than 5th percentile of the same gender, age, height,
• At risk of dehydration or volume depletion,
• Evidence of liver disease: defined by serum levels of alanine transaminase or aspartate transaminase >2 times the upper limit of normal during screening,
• History of organ transplantation, cancer, liver disease,
• History of noncompliance to medical regimens or unwillingness to comply with the study protocol.