Study sitting: Nephrology and renal transplant unit at urology and nephrology center in Mansoura University.~Study design and sample size:~Randomized, controlled trial that will include 100 patients with Lupus nephritis (LN) with an estimated glomerular filtration rate of 25-75 ml/min/1.73m2. Diagnosis of LN was performed by renal biopsy, and all of the renal biopsies were carried out at urology and nephrology center.~The patients will be randomized into two groups Study group: will receive SGLT2i as add on drug or replace another drug according to the patient clinical situation, Dapagliflozin 10 mg will be used once daily with or without food.~Control group: will be maintained on their medication.~Study Protocol:~Patients in the study group will treated with dapagliflozin initiated at a total daily dosage of 10 mg once daily.~Methods:~The following data will be gathered and evaluated for all patients:~I-before intervention:~Patients of both groups will be subjected to full history taking including duration of LN and drug history and routine clinical examination including blood pressure and BMI measurements.~Laboratory investigations:~Serum creatinine, Creatinine clearance. 24 hour urine protein, urine protein/creatinine ratio. Urine analysis. HBA1c. hemoglobin (HGB). Uric acid and lipid profile. Lupus serology. immunoreactive parathyroid hormone (iPTH). Vitamin D level. Fibroblast growth factor 23 level. bone turnover markers : bone specific alkaline phosphates propeptides of type 1 procollagen tartrate resistant acid phosphatase 5b sclerostin level~Radiological investigation:~Quantitative computed tomography: to detect bone and mineral density (BMD). Cardiovascular assessment: Echocardiography and vascular calcification incidence (NCCT model) : for detection of coronary calcification.~II-after intervention:~All patients will be evaluated monthly regarding:~Regular measurement of blood pressure each visit.~Laboratory investigations:~Serum creatinine, creatinine clearance. 24 hour proteinuria, protein/creatinine ratio. Fasting, random and postprandial glucose levels. calcineurin inhibitors (CNI) trough level if used. Urine analysis. HGB level. Uric acid, lipid profile. Lupus serology.~All patients will be evaluated every 3 month regarding:~iPTH~Vitamin D level~All patients will be evaluated at 12 month regarding:~Fibroblast growth factor 23 level~High resolution quantitative computed tomography.~Bone turnover markers.
The goal of this Randomized, controlled trial in 100 patients with LN with an estimated glomerular filtration rate (eGFR) of 25-75 ml/min/1.73m2. Diagnosis of LN was performed by renal biopsy, and all of the renal biopsies were carried out at urology and nephrology center.~1. The main questions it aims to answer are:~Assess the role of sodium glucose co transporter 2 inhibitors (SGLT2i) in regression of ongoing kidney and cardiac diseases among diabetic or non-diabetic patients with lupus nephritis (LN) under different immunosuppressive therapies.~Investigate the impact of SGLT2i on bone and mineral metabolism in these patients.~Participants will be randomized into two groups :~Study group: will receive SGLT2i as add on drug or replace another drug according to the patient clinical situation, Dapagliflozin 10 mg will be used once daily with or without food.~Control group: will be maintained on their medication.