All patients have been recruited from the renal clinic of Nephrology and transplantation unit. The entire study will be conducted at Urology and Nephrology center in Mansoura University.~Study design and sample size:~• Sample size: Was calculated based on previous research by (DAPA-CKD) study using G. power program with α error 0.05 and power 80% and it was equal to approximately 98 patients.~Type of the study: Randomized, controlled trial.~Patient's enrollment: 100 patients with non-diabetic CKD with an estimated glomerular filtration rate (eGFR) of 25-75 ml/min/1.73m2 will be randomized into two groups:~Study group: includes 50 patients, they will receive SGLT2i as add on drug, Dapagliflozin 10 mg will be used once daily with or without food.~Control group: includes 50 patients, they will receive placebo plus their medication.~The investigators will follow up all patients for 12 months and compare their results.~Study Protocol:~• 100 patients will be included in the study. Patients will be randomized 1:1, either to a control group receiving placebo and an intervention group receiving 10 mg dapagliflozin daily.~The following data will be gathered and evaluated for all patients:~I- Baseline evaluation:~Patients of both groups will be subjected to full history taking including duration and cause of CKD and drug history and routine clinical examination.~Laboratory investigations:~Serum creatinine, calcium, phosphorus and magnesium.~24 hour urine protein, Creatinine clearance, calcium and phosphorus~Urine analysis with microscopy and random urine protein/creatinine ratio.~Random blood sugar.~Intact parathyroid hormone (iPTH).~Urine pregnancy test for females in child bearing period.~Bone turnover markers:~Bone-specific alkaline phosphatase (BALP).~Propeptides of type I procollagen (P1NP).~Carboxy-terminal crosslinked telopeptide of type 1 collagen (CTX-1).~Tartrate-resistant acid phosphatase (TRAP-5b).~Radiological investigation:~Quantitative computed tomography: to detect cortical and trabecular bone density.~II-Evaluation throughout the study:~All patients will be evaluated every 3 months thereafter regarding:~Thorough clinical evaluation including regular measurement of blood pressure and assessment of volume status each visit.~Laboratory investigations:~Serum creatinine, calcium, phosphorus and magnesium.~24 hour urine protein, Creatinine clearance, calcium and phosphorus~Urine analysis with microscopy and random urine protein/creatinine ratio.~Random blood sugar.~All patients will be evaluated at 12 month regarding:~iPTH~Bone turnover markers:~Bone-specific alkaline phosphatase (BALP)~Propeptides of type I procollagen (P1NP).~Carboxy-terminal crosslinked telopeptide of type 1 collagen (CTX-1).~Tartrate-resistant acid phosphatase (TRAP-5b).~Quantitative computed tomography (QCT).~The main research question is: Does use of SGLT2i will slow down the progression of CKD in patients without diabetes? Will the use of SGLT2i have a negative impact on bone and mineral metabolism among these patients?
It is a randomized controlled trial in which 100 non diabetic chronic kidney disease (CKD) patient is being participated.~Their estimated glomerular filtration rate (eGFR) between 25-75 ml/min/1.73 m2.~Participants will be randomized into two groups:~Study group: includes 50 patients, they will receive Sodium glucose co-transporter 2 inhibitor (SGLT2i) as add on drug, Dapagliflozin 10 mg will be used once daily with or without food.~Control group: includes 50 patients, they will receive placebo their medication.~The investigators will follow up all patients for 12 months and compare their results.~This study aims to:~Assess SGLT2i role in delaying the progression of ongoing chronic kidney disease.~Study the impact of SGLT2i on bone and mineral metabolism in this patients' population.