Proteinuria reduction with SGLT2 inhibitors in a patient treated with tyrosine kinase inhibitor lenvatinib

We describe the case of a 66-year-old woman treated with tyrosine kinase inhibitor Lenvatinib for thyroid carcinoma who had persistent proteinuria above 2 g/24 h despite maximal dose of angiotensin-converting enzyme inhibitor. We initiated a treatment with SGLT2 inhibitor Dapagliflozin. Three months after Dapagliflozin initiation, her proteinuria decreased to 1 g/24 h, and after 6 months of follow-up was 0.6 g/24 h. To our knowledge, this is the first case of successful proteinuria reduction with SGLT2i in a patient treated with Lenvatinib. Specific renal effects of SGLT2i seem promising and their effects on tyrosine kinase inhibitor renal adverse effects need to be validated in clinical trials involving cancer patients.

Automated summary

We present a case of a 66-year-old woman with thyroid carcinoma who had persistent proteinuria despite maximal angiotensin-converting enzyme inhibitor dose. Treatment with SGLT2 inhibitor Dapagliflozin resulted in a significant reduction in proteinuria after 3 months. This is the first reported case of successful proteinuria reduction with SGLT2i in a patient treated with tyrosine kinase inhibitor.