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Effects of Dapagliflozin on Renal Function, Body Composition and Metabolic Parameters in People with HIV and Chronic Kidney Disease

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04 November 2026

Posted:

06 November 2026

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Abstract
Background: Kidney disease is an increasingly important comorbidity in people with HIV (PWH), owing to its association with mortality and cardiovascular (CV) disease, a leading cause of non-AIDS-related death. Sodium–glucose cotransporter 2 inhibitors (SGLT2 inhibitors) have demonstrated renal and cardiovascular protective effects in the general population, but evidence in PWH remains scarce. We aimed to evaluate the safety and clinical effects of dapagliflozin in PWH with chronic kidney disease (CKD). Methods: We enrolled adult PWH with an estimated glomerular filtration rate (eGFR) of 25–75 mL/min/1.73 m² who were receiving stable antiretroviral therapy and had sustained HIV virological suppression. Participants received dapagliflozin 10 mg once daily according to routine clinical practice. Safety and efficacy outcomes, blood and urine biochemistry, 24-hour ambulatory blood pressure monitoring, adipose and muscle composition, and body water distribution were assessed. Analyses were performed in the overall cohort and stratified by gender and diabetes status. Results: Thirty-seven participants were included. Most were cisgender men (78%), and the median age was 60 years. One participant discontinued treatment because of dizziness. Renal parameters showed a consistent, although non-significant, trend toward improvement. Haematocrit and haemoglobin increased significantly in the overall cohort (both p < 0.001). HDL cholesterol increased significantly among participants with diabetes (p = 0.034). Body mass index (BMI) decreased from 26.48 kg/m² (IQR 24.00–29.38) to 26.22 kg/m² (IQR 23.58–28.42; p < 0.001), and waist circumference decreased from 102.3 cm (IQR 92.4–108.8) to 101.6 cm (IQR 90.85–107.55; p = 0.009). In men, rectus femoris cross-sectional area decreased significantly from 7.12 cm² to 6.65 cm² (p = 0.033), although no significant DXA-assessed changes in muscle composition were observed. All ultrasound-assessed abdominal fat layers decreased, but only omental fat thickness reached statistical significance, decreasing from 75.2 mm (IQR 39.6–81.9) to 58.6 mm (IQR 44.1–73.5; p = 0.029). The extracellular water-to-total body water ratio increased significantly in the overall cohort, from 0.378 (IQR 0.372–0.387) to 0.379 (IQR 0.372–0.387; p = 0.044), and among participants with diabetes, from 0.381 (IQR 0.375–0.388) to 0.383 (IQR 0.383–0.392; p = 0.014). Conclusions: In this cohort of PWH with CKD, dapagliflozin was well tolerated and associated with a trend toward improved renal function, together with significant reductions in BMI, waist circumference and omental fat thickness, a marker of cardiometabolic risk. Longer follow-up and larger studies are needed to confirm these benefits and determine their impact on cardiovascular outcomes.
Keywords: 
renal disease
;  
dapagliflozin
;  
aging
;  
body composition
;  
abdominal fat layers
;  
HIV
;  
cardiovascular risk
Subject: 
Medicine and Pharmacology  -   Epidemiology and Infectious Diseases

Introduction

Chronic kidney disease (CKD) is a major contributor to morbidity, mortality and impaired quality of life in the general population, and remains a critical comorbidity among people with HIV (PWH) (1,2). The prevalence of CKD in PWH has increased over recent decades as life expectancy has improved, as observed in our cohort and in other studies (3,4). Beyond its direct effect on kidney health, CKD is strongly associated with cardiovascular (CV) disease, which occurs at higher rates among PWH even after adjustment for traditional risk factors (5).
The increasing burden of CKD in PWH parallels the rising prevalence of diabetes and obesity, two major drivers of CKD pathogenesis and established cardiovascular risk factors. The global prevalence of diabetes continues to increase, driven by lifestyle-related factors and, among PWH, also by HIV infection itself and specific antiretroviral therapy (ART) exposures (6,7). Similarly, increasing rates of overweight and obesity have been reported in PWH, partly associated with certain ART classes, contributing to an adverse cardiometabolic profile in this population (8,9).
Together, these conditions represent a substantial cardiovascular burden in PWH. Because CKD confers additional cardiovascular risk independently of traditional risk factors, disease-modifying therapies capable of slowing CKD progression while mitigating CV risk are urgently needed. Sodium–glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glycaemic control, have transformed the therapeutic landscape of CKD through robust renal and CV protective effects in people with and without diabetes. Their pleiotropic mechanisms include glycosuria, natriuresis and attenuation of glomerular hyperfiltration, which translate into weight reduction, blood pressure lowering and improvements in insulin resistance (10–14). Large-scale trials and meta-analyses have consistently shown that SGLT2 inhibitors reduce the risk of CKD progression and acute kidney injury, as well as CV-related death and hospitalisation for heart failure, independently of CKD aetiology and baseline kidney function (10,15–17). Beyond these effects, dapagliflozin may exhibit an anti-inflammatory profile in PWH, characterised by inhibition of inflammasome activation and monocyte–macrophage activation, which could provide additional cardiovascular benefit (18).
In light of this evidence, contemporary clinical practice guidelines recommend SGLT2 inhibitors as foundational therapy for patients with CKD, with or without diabetes mellitus, and for those with heart failure. In Spain, dapagliflozin 10 mg once daily is approved for CKD in people with eGFR ≥25 mL/min/1.73 m², irrespective of diabetes status. However, data evaluating the benefits of SGLT2 inhibitors in PWH are limited. In a small cohort of PWH with diabetes treated with canagliflozin, clinically meaningful reductions in body weight and fasting glucose were observed without serious adverse events (19).
The present study aimed to evaluate the renal, metabolic and body composition effects of dapagliflozin in virologically suppressed PWH with mild-to-moderate CKD attending a tertiary hospital.

Material and Methods

Study Design and Population

This was a phase IV, open-label, single-arm, single-center, prospective study including adult PWH with mild-to-moderate CKD who were eligible to initiate treatment with dapagliflozin as part of their routine clinical care. The inclusion criteria were: eGFR) 25- 75 mL/min/1.73 m², with or without abnormal urinary albumin-to-creatinine or protein-to-creatinine ratios (>30 mg/day and >200 mg/day, respectively), a stable ART regimen, and HIV viral suppression (<20 copies/mL) at least for 6 moths previous to the study baseline. Exclusion criteria included the requirement for dialysis requirement, acute infections, active malignancy, and pregnancy or lactation.
Participants who met the eligibility criteria and provided written informed consent were consecutively enrolled. The study protocol was approved by the institutional Ethics Committee (reference no. PI-23-100). The study was conducted in accordance with the principles of the Declaration of Helsinki (Fortaleza, Brazil, October 2013) and complied with Spanish national regulations (Real Decreto 1090/2015 and Orden SAS/3470/2009). Participants received dapagliflozin 10 mg once daily in accordance with standard clinical practice.

Objectives

The primary objective was to assess the safety and renal effects of dapagliflozin in PWH with CKD. Secondary objectives included evaluation of changes from baseline to week 48 in body weight and body composition, including lean mass, fat mass, body water distribution and hepatic steatosis, as well as changes in metabolic parameters.

Study Variables

Study Variables Collected at Screen Visit

Demographic (age, sex at birth, gender, race), HIV-related variables at screen (CD4+ cell count, HIV viral load and ARV regimen), and concomitant comorbidities were collected from medical records.

Study Variables Collected Every 3 Months

Adverse events and clinical events, including comorbidities, treatment changes, hospital admissions and deaths, were recorded every 3 months during follow-up.
Every 3 months, caloric intake (dietary diary), physical activity (International Physical Activity Questionnaire [IPAQ]), and anthropometric measurements, including height, weight, body mass index (BMI), waist circumference and abdominal circumference, were assessed.

Study Variables Collected Every 6 Months

Ultrasound imaging was performed using a General Electric LOGIQ E ultrasound device with a 12-MHz linear probe and a 5-MHz convex probe, as previously described (20). Assessments were performed at baseline, week 24, and the final visit, and included supra-aortic trunk atherosclerosis, cIMT, abdominal fat layers (total, superficial and deep subcutaneous fat thickness; preperitoneal, omental and bilateral perirenal fat thickness), all measured at L5 (20), epicardial fat thickness and muscle composition (rectus femoris thickness and area, myofibrillar insertion angle and muscle echogenicity using quantitative pixel measurement and the qualitative Heckmatt scale).
Body water compartments were measured using multifrequency segmental bioelectrical impedance analysis (InBody S10, Biospace Co., Ltd., Seoul, Republic of Korea; LookingBody 120 software). Total body water, intracellular water and extracellular water-to-total body water ratio were assessed for the limbs and trunk at baseline and weeks 12, 24 and 48.
At baseline and weeks 24 and 48, 24-hour ambulatory blood pressure monitoring, echocardiography with left ventricular end-diastolic volume measurement, and blood and urine tests were performed. Laboratory measurements included: urea, creatinine, eGFR, urinary albumin-to-creatinine ratio, urinary protein-to-creatinine ratio, insulin, glucose, HbA1c, magnesium, uric acid, lipid profile (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), liver profile (AST, ALT and GGT), HOMA index, HIV viral load and CD4+ and CD8+ cell counts.

Study Variables Collected at Baseline and Final Visit

At baseline and the final visit, liver stiffness measurements were performed to evaluate hepatic steatosis by elastography. Dual-energy X-ray absorptiometry (DXA) scans (LUNAR DPX-L, General Electric, Madison, WI, USA) were used to assess body composition, including total, trunk, arm and leg lean and fat mass. Appendicular lean mass index (ALMI), calculated as appendicular lean mass adjusted for height squared, was used as a marker of muscle mass.

Statistical Analyses

A computerised database was created for data management. Quantitative variables were summarised using mean, standard deviation, median, interquartile range and minimum and maximum values. Categorical variables were summarised using absolute and relative frequencies.
Between-group comparisons were performed using Student’s t-test, the Mann–Whitney U test, the chi-squared test or Fisher’s exact test, according to variable distribution.
Quantitative variables were described using measures of central tendency and dispersion, and were presented graphically using box plots.
Changes between baseline and week 48 were assessed using, paired-data methods, with the difference between the two measurements (week 48 minus baseline) used as the analysis variable. The normality of the paired differences was evaluated using the Shapiro-Wilk test. In cases of normality (p>0.05), Student’s t-test for paired samples was used; otherwise, the non-parametric Wilcoxon test was applied.
Analyses were stratified by diabetes status and gender using the same analytical approach.
Associations between quantitative variables were assessed using Pearson’s correlation coefficient. Statistical significance was set at p < 0.05. All participants who completed at least one post-baseline procedural visit were included in the final analysis.

Results

Baseline Participants’ Characteristics

A total of 37 individuals were enrolled. Most participants were cisgender men (78%), and the median age was 60 (56–63) years HIV viral load was suppressed in all participants, and the median baseline CD4+ cell count was 469.5 cells/μL (IQR 372.75–774.5). The most frequent comorbidities were hypertension (70%), type 2 diabetes mellitus (39%) and dyslipidaemia (30%) while obesity was present in 19% of participants. Baseline characteristics are summarized in Table 1.

Clinical Events and Safety Outcomes

One participant discontinued dapagliflozin during the first days of treatment because of dizziness. Two participants developed urinary tract infections, both resolved without complications with antibiotic treatment. No changes in concomitant medications or ART were required during follow-up. No clinical events, hospitalizations, or additional adverse events, whether related or unrelated to the study drug, were reported.

Evolution of Renal Measurements

According to KDIGO criteria, 12 participants were classified as G2; 10 as G3a, 15 as G3b and no participants had criteria of G4. Abnormal urinary albumin-to-creatinine and/or protein-to-creatinine ratios were present in 22 participants (60%). All renal parameters showed a modest improvement yet at week 24 and until week 48, although none reached statistical significance (Table 2). Briefly, median serum creatinine decreased from 1.42 mg/dL (IQR 1.15–1.65) to 1.35 mg/dL (IQR 1.18–1.57), while median CKD-EPI estimated glomerular filtration rate increased from 47 mL/min/1.73 m² (IQR 42–67) to 53 mL/min/1.73 m² (IQR 38.75–66). Median urinary albumin-to-creatinine ratio decreased from 163.6 mg/g (IQR 37.62–369.55) to 133 mg/g (IQR 17.75–324.5), and median protein-to-creatinine ratio decreased from 361 mg/g (IQR 140–848) to 341 mg/g (IQR 169–566) (all p = NS). No significant differences were observed by gender or diabetes status. The evolution of renal parameters throughout follow-up is summarized in Table 2.

Blood Pressure, Vascular and Laboratory Parameters

Systolic and diastolic blood pressure showed an overall downward trend; however, statistically significant reductions were observed only among participants with diabetes in whom median diastolic blood pressure decreased from 79 (IQR 74.5–79.5) to 73 mmHg (IQR 71–74) (p = 0.016).
In 24-hour ambulatory blood pressure monitoring, blood pressure load decreased across all evaluated time points and reached statistical significance at week 24 (p = 0.034) , although this effect was not maintained at week 48. No significant changes in cIMT or supra-aortic trunk atherosclerosis were observed during follow-up.
Haematocrit and haemoglobin increased significantly in the overall cohort (both p < 0.001). HDL cholesterol increased significantly among participants with diabetes (p = 0.034). Glucose, insulin, and HOMA index improved significantly from baseline to week 48 in the overall population (p =0.001, p =0.001, and p <0.001, respectively). A significant improvement in HOMA index was also observed in men (p =0.004), but not in women.

Weigh, Anthropometric Measurements and Body Composition

Dietary intake and physical activity assessed using food diaries and the IPAQ, respectively, remained stable throughout follow-up.
Significant reductions in body weight were observed in the overall cohort, with median weight decreasing from 75 (IQR 71–86) to 74 kg (IQR 67–84) (p = 0.001). Median BMI decreased from 26.5 (IQR 24–29) to 26.2 kg/m² (IQR 23-28.42 p <0.001). Waist circumference also decreased significantly, from 102.3 (IQR 92.4–108.8) to 101.6 cm (IQR 90.85–107.55, p =0.009). Subgroup analyses by gender and diabetes status showed a trend towards weight reduction, with slightly greater weight loss in men than in women (2.6 versus 2 kg at final visit) and in participants with diabetes than in those without diabetes (2.5 versus 0.7 kg); however, these subgroup differences did not reach statistical significance.
DXA-derived ALMI showed a small, non-significant decrease from 8.70 (IQR 8.10–9.15) to 8.50 kg/m² (IQR 8.28–9.03; p = NS). Because ALMI is a useful tool for detecting sarcopenia, the absence of sarcopenia at baseline or at the final visit is notable. Values remained within the normal range in both women and men. Overall, muscle-related ultrasound parameters also tended to decrease during follow-up. Rectus femoris thickness decreased from 16.2 mm (IQR 15.0–18.1) to 15.4 mm (IQR 13.2–17.7; p = NS), and rectus femoris area decreased from 7.04 cm² (IQR 5.95–8.13) to 6.37 cm² (IQR 5.61–7.43; p = NS). A statistically significant reduction in rectus femoris area was observed only in men, decreasing from 7.12 to 6.65 cm² (p = 0.033).
DXA scan showed stable total, limb and trunk fat mass: total body fat percentage changed from 32.9 (26.6–38.3) to 30.9 (26.4–38.5) %, and total trunk fat percentage changed from 39.2 (31.9–43.4) to 36.9 (29.7–43.8) %, with no statistically significant differences in both cases (Table 3).
Abdominal fat layers generally decreased during follow-up, although only omental fat thickness decreased significantly from 75.2 (IQR 39.6–81.9) to 58.6 mm (IQR 44.1–73.5, p = 0.029). No significant changes were observed in other fat depots, including epicardial fat thickness.

No Significant Changes Were Detected in Hepatic Steatosis

Intracellular water decreased across the compartments analysed and reached statistical significance in the trunk in the overall cohort, decreasing from 12.0 (IQR 11.0–13.0) to 11.7 L (IQR 10.8–12.6; p = 0.029), and in men, decreasing from 12.0 (IQR 11.5–13.5) to 11.9 L (IQR 11.1–12.8; p = 0.001). The extracellular water-to-total body water ratio increased significantly in the overall cohort, from 0.378 (IQR 0.372–0.387) to 0.379 (IQR 0.372–0.387; p = 0.044), and among participants with diabetes, from 0.381 (IQR 0.375–0.388) to 0.383 (IQR 0.383–0.392; p = 0.014).
Body composition measurements by DXA scan, ultrasonography and BIA are summarized in Table 3.

Discussion

This study confirms the safety of dapagliflozin in PWH with mild-to-moderate CKD and suggest a favourable trend in renal parameters, without evidence of clinical progression during follow-up, together with significant reductions in glucemic parameters, blood pressure, body weight and omental fat thickness.
The beneficial effects of dapagliflozin in the population without HIV are well established, particularly regarding glycaemic control and slowing the progression of CKD (12,15,17,19). However, evidence in PWH remains limited. To our knowledge, this is the first prospective clinical study to evaluate the safety and efficacy of dapagliflozin in PWH with mild-to-moderate CKD considering renal, metabolic and clinical outcomes, with an exhaustive evaluation of body composition in the overall population and according to gender and diabetes status.
The first key finding of this study is the good tolerability of dapagliflozin. A favourable safety profile is particularly important in PWH, given the potentially increased susceptibility to infections and the high burden of comorbidities among individuals with both renal disease and HIV. Although follow-up was limited to 48 weeks, no clinical progression, hospitalisations or cardiovascular events were observed during the study.
Previous case reports and observational studies have suggested potential renal benefits of dapagliflozin in PWH, although results showed some discrepancies, with studies reporting stabilization of renal function and others presenting only a slower rate of decline (18,21). These studies were limited by small sample sizes and heterogeneous follow-up periods. In our cohort, analysis from the overall population and relevant subgroups (by gender and diabetes status), suggest a potential protective effect against deterioration of renal function over one year. Numerical favourable changes were observed not only in eGFR but also in urinary albumin-to-creatinine and protein-to-creatinine ratios, parameters that had not been assessed in previous reports. The benefit in urine parameters were evident as early as 6 months after treatment initiation, even among participants with moderate albuminuria or proteinuria. Although these changes did not reach statistical significance, probably because of the small sample size and heterogeneous baseline values, the overall trends consistently favoured a beneficial renal effect of dapagliflozin.
Additional improvements were observed in glucose metabolism, haematocrit and blood pressure, all of which are recognized effects of SGLT2 inhibitors and may also be partly mediated through improvements in renal physiology. HDL cholesterol increased among participants with diabetes, representing a potentially favourable cardiovascular effect in a subgroup already at elevated cardiovascular risk due to both diabetes and HIV infection. In contrast with some previous cohorts, no significant changes in triglyceride levels were detected in the overall cohort or in the subgroups (18).
A novel aspect of this study is the comprehensive assessment of body composition, which allowed detailed characterisation of body changes during dapagliflozin therapy. Significant weight loss is an expected effect of this drug (20), and was consistent with the observed reductions in waist circumference and abdominal adipose tissue. Despite considerable differences of weight loss between gender and diabetes status, the differences do not achieved significance, probably because the reduced number of persons in each subgroup. Although numerically greater weight loss was observed in men and in participants with diabetes, these subgroup differences did not reach statistical significance, probably because of the small number of participants in each subgroup.
In our study, DXA-derived lean mass measures, including trunk and limb lean mass and ALMI, did not change significantly. A reduction in muscle mass could be anticipated with weight-lowering therapies, as has been reported with other agents such as semaglutide. The stability of ALMI during follow-up is clinically relevant because sarcopenia is an important ageing-related condition in PWH, with implications for frailty and functional decline (22). Results for muscle evolution were broadly consistent across methods: DXA, considered the reference standard for lean mass assessment, and ultrasound, used as an alternative method to assess rectus femoris muscle changes. The significant reduction in rectus femoris area observed only among men should be interpreted with caution because of the small subgroup size. Differences according to gender further emphasise the importance of gender-stratified analyses in body composition studies, regardless of the underlying condition being investigated.
All abdominal fat depots decreased over time, with a significant reduction observed only in omental fat thickness. Omental adiposity has been strongly associated with hypertension, insulin resistance and atherosclerotic burden, and reductions in this fat layer have been linked to improvements in cardiovascular risk (20). This finding is particularly relevant in PWH, who have higher cardiovascular risk than the general population (5). By contrast, perirenal adipose tissue did not achieved significance, differing from findings in the general population with more advanced renal disease, in whom perirenal fat has been consistently identified as the adipose compartment most strongly associated with renal function and kidney disease progression (23–25). This discrepancy may be explained by the relatively mild degree of renal impairment in our cohort, but HIV-related factors may also contribute to differential patterns of abdominal fat distribution. A previous study comparing abdominal fat layers in PWH and HIV-negative controls matched by age, sex and BMI showed differences in preperitoneal fat, suggesting HIV-mediated alterations in fat distribution (26). People with long-term HIV infection may also have lipodystrophy, a condition that alters trunk fat accumulation. Lipodystrophy was not formally assessed in our study, although most participants had long-standing HIV infection.
The increase in extracellular water-to-total body water ratio, together with changes in intracellular water, may reflect alterations in fluid distribution or cell membrane integrity, with potential long-term clinical implications.
This study has several limitations. First, the relatively small sample size may have limited the ability to detect statistically significant differences. Second, the mild-to-moderate severity of renal impairment and heterogeneity of proteinuria may have reduced the ability to identify treatment-related renal benefits. Similarly, the considerable variability in body composition, including the presence of obesity in a substantial proportion of participants, may have influenced the observed results. Third, follow-up duration was insufficient to evaluate long-term clinical outcomes, disease progression or cardiovascular events. Finally, inflammatory biomarkers were not assessed. Because these markers may contribute to mechanisms underlying weight loss and cardiovascular risk reduction associated with SGLT2 inhibitors, their assessment should be considered in future studies.

Conclusion

In conclusion, in this cohort of PWH with mild-to-moderate CKD, dapagliflozin demonstrated a favourable safety profile and appeared to exert renoprotective effects. No significant reduction in DXA-assessed lean mass was observed. Treatment was associated with significant reductions in body weight and omental fat thickness, as well as improvements in HDL cholesterol, glucose metabolism and blood pressure, all of which are closely related to cardiovascular risk. This is particularly relevant in PWH, in whom cardiovascular risk remains a major concern beyond diabetes mellitus or kidney disease. In addition to its expected metabolic effects, the clinical relevance of dapagliflozin in PWH lies in the increased burden of renal and cardiovascular disease in this population, compounded by ageing, chronic immune activation and persistent inflammation. Although experience with SGLT2 inhibitors in PWH remains limited, our findings support their potential role in this setting and suggest that their use may increase in the coming years. Larger studies with longer follow-up are required to confirm these observations and determine whether the observed metabolic and renal benefits translate into reductions in future clinical and cardiovascular events.Summary of Tables and Figures:
Table 1: Demographics.
Table 2: Renal outcomes.
Table: 3. Body composition measurements.
Figure 1: Significant variables in the overall population.

Funding

These findings were partially presented at the XVI Congreso Nacional GeSIDA, Granada, Spain, 25 November 2025.

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Table 1. Baseline characteristics of the participants.
Table 1. Baseline characteristics of the participants.
Race caucasic , % (n) 90% (33/37)
Age, years, median (IQR) 60.5 (56-63)
Gender,
cisgender men , % (n)
cisgender women, % (n)
trans men, % (n)
trans women, % (n)
Other genders, % (n)
78% (29/37)
22% (8/37)000
Weigh (Kg) 79.79 (70.65-85.5)
BMI
BMI>30 %, n 		27.43 (24-29.38)
19% (7/37)
Current CD4+ T-cell count at baseline, cells/µl
Median, IQR
N,% 		469.5 (372.75-774.5)
31.55 (24-38)
Undetectable HIV viral load, % (n) 100% (37/37)
Number of comorbidities (rang) 3-14
Arterial
hypertension, % (n) 		70% (26/37)
Diabetes mellitus, % (n) 39% (14/37)
Cardiovascular disease, % (n) 24% (9/37)
Dislipemia, % (n) 30 % (11/37)
IQR: interquartile rang, BMC: body mass index.
Table 2. Renal outcomes.
Table 2. Renal outcomes.
Baseline W48 P value (BL vs W48)
Urea (mg/dl)
Median, IQR
Mean, SD
51 (42;57)
50.27 (15.0)
51.35 (40.5;60.98) 49.96 (20.475) 		0.8941
Creatinine (mg/dl)
Median, IQR
Mean, SD
1.42 (1.15;1.65)
1.44 (0.5)
1.35 (1.18;1.57)
1.41 (0.385)		 0.4939
CKP EPI mL/min/1.73 m2
median, IQR
mean, SD
47 (42;67)
53.51 (25.0)
56 (38.75;66)
55.62 (27.25)		 0.4578
Urine albumin/creatinine ratio
mg/g
median, IQR
mean, SD

163.6 (37.62;369.55)
262 (331.925)

133 (17.75;324.5)
268.55 (306.75)		 0.2894
Urine protein/creatinine ratio
Mg/g
median, IQR
mean, SD

361 (140;848)
474.87 (708.0)

341(169;566)
508.84 (397)		 0.6497
IQR: Interquartile rang; SD: standard deviation; W48: Week 48; BL: Baseline.
Table 3. Body composition measurements.
Table 3. Body composition measurements.
Baseline W48 P value
(BL vs W48)
DXA results
Fat mass (%)
Total arms
28.35 (23.8–30.75)
 27.6 (23.95– 36.2) 0.451
Total legs
26.35 (21–31) 25.8 (20.85– 31.55) 0.451
Total trunk
39.2 (31.92–43.4) 36.9 (29.7– 43.75) 0.996
Total body
 32.9 (26.62–38.33) 30.9 (26.4– 38.55) 0.909
Lean mass (gr)
Total arms
5,923.5 (5,146.5–6,404) 5,603 (5,149– 6,416) 0.443
Total legs
16,394.5 (15,173–17,961) 16,464 (14,920.5– 17,347.5) 0.241
Total trunk
25,145.5 (21,460.25–28,491.25) 25,587 (21,726.5– 28,660) 0.263
Total body
 50,930 (45,238.75–54,768.5) 50,809 (45,461.5–54,828) 0.173
ALMI (kg/m²)
8.70 (8.10–9.15) 8.50 (8.28–9.03) 0.222
Ultrasonography results
Fat layers (mm)
Epicardial 6.7 (6–7.5) 6.55 (6.1–7.15) 0.234
Abdominal total subcutaneous 14 (11.1–22.1) 13.5 (9.95–20.68) 0.111
Abdominal superficial subcutaneous 5.6 (4.6–7.9) 5.55 (4.55–7.98) 0.191
Abdominal deep subcutaneous 6.9 (6–12.7) 7.75 (5.32–12.45) 0.564
Preperitoneal 3.5 (3–5) 3.4 (2.18–4.55) 0.113
Omental 75.2 (39.6–81.9) 58.6 (44.1–73.5) 0.029
Left perirenal 14.9 (10.55–22.2) 12.8 (10.55–20.12) 0.067
Right perirenal 13.8 (10–22.2) 18.5 (11.22–22.28) 0.524
Femoral muscle measurements
Rectus femoris area (cm2) 7.04 (5.95–8.13) 6.37 (5.61–7.43) 0.132
Rectus femoris thickness (mm) 16.2 (15.0–18.1) 15.4 (13.2–17.7) 0.909
Myofibrillar insertion angle 11.2 (9–13.7) 10.25 (9.07–12.2) 0.405
Muscle echogenicity using quantitative pixel measurement 65 (63–67.5) 64.8 (63.53–66.35) 0.820
Muscle echogenicity using qualitatively pixel measurement (Heckmatt scale), n (%) G1 (normal):26 (72%)
G2:9 (25%)
G3:0
G4:1(3%)		 G1 (normal):27 (75%)
G2:8 (22%)
G3:0
G4:1 (3%)		 0.564
BIA results
Intracellular water (L) 12.0 (11.0–13.0) 11.7 (10.8–12.6) 0.029
Extracellular water-to-total body water ratio 0.378 (0.372–0.387) 0.379 ( 0.372–0.387) 0.044
IQR: Interquartile rang; W48: Week 48; BL: Baseline; DXA: Dual-energy X-ray absorptiometry; BIA: bioelectrical impedance analysis. Values are expressed as median and IQR unless otherwise specified.
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