Effect of Glycosuria on Urinary Protein in Patients With Chronic Kidney Disease Treated With SGLT2 Inhibitors

Inclusion Criteria: Age ≥18 years. Patients with a confirmed diagnosis of chronic kidney disease (CKD). Currently receiving stable, standard-dose SGLT2i therapy at screening. Proteinuria ≥0.15 g/24 h (or urine protein-to-creatinine ratio \[UPCR\] ≥440 mg/g or urine albumin-to-creatinine ratio \[UACR\] ≥300 mg/g) at screening. Estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73m² calculated by the CKD-EPI creatinine equation at screening. Willing and able to provide written informed consent. Exclusion Criteria: Discontinuation of SGLT2i during the follow-up period. History of symptomatic hypotension (systolic blood pressure\<90 mmHg) without antihypertensive medication, or current hypotensive episode at screening. Unstable renal function (e.g., acute kidney injury or rapidly progressive glomerulonephritis with a \>50% decline in eGFR within 3 months prior to screening). Use of corticosteroids or having an indication for corticosteroid therapy within the past 6 months. Receipt of immunosuppressive therapy or having an indication for immunosuppressive therapy within the past 6 months. History of intolerance to SGLT2 inhibitors. History of ketoacidosis within the past 5 years.