HIV patients taking tenofovir, a common antiretroviral drug, sometimes experience kidney damage as a side effect. Researchers tested whether dapagliflozin, a medication typically used for diabetes, could protect the kidneys from this damage. In a study using rats, dapagliflozin appeared to reduce kidney injury by decreasing harmful stress molecules, reducing inflammation, and preventing cell death. The findings suggest this drug combination might help HIV patients maintain healthier kidneys while staying on their life-saving antiretroviral therapy.

The Quick Take

  • What they studied: Whether a diabetes medication called dapagliflozin could prevent kidney damage caused by tenofovir, a common HIV treatment drug.
  • Who participated: Laboratory rats divided into four groups: a control group, a group receiving tenofovir only, a group receiving dapagliflozin only, and a group receiving both medications together.
  • Key finding: Rats that received both tenofovir and dapagliflozin showed significantly better kidney function and less cellular damage compared to rats receiving tenofovir alone. The dapagliflozin appeared to reduce harmful inflammation and prevent kidney cells from dying.
  • What it means for you: This research suggests that adding dapagliflozin to tenofovir treatment might help protect HIV patients’ kidneys from damage. However, this is early-stage research in animals, and human studies are needed before doctors could recommend this approach. If you take tenofovir, discuss kidney health monitoring with your doctor.

The Research Details

Researchers used laboratory rats to test whether dapagliflozin could protect kidneys from tenofovir damage. They divided 32 rats into four equal groups. The first group ate normal food for 45 days (control). The second group ate food mixed with tenofovir for 45 days to mimic the kidney damage seen in HIV patients. The third group ate normal food but received dapagliflozin in the last 15 days. The fourth group received tenofovir for the full 45 days plus dapagliflozin in the final 15 days.

After the study period, researchers examined the rats’ kidneys and blood to measure kidney function, inflammation levels, cell damage, and protective molecules. They used specialized laboratory techniques to measure specific markers of kidney health and cellular stress.

This controlled animal study design allows researchers to isolate the effects of dapagliflozin on tenofovir-induced kidney damage without the complexity of human variables. By measuring multiple markers of kidney function and cellular health, the researchers could understand not just whether the drug helped, but how it worked at the cellular level. This foundation is necessary before testing in humans.

This study was published in Scientific Reports, a reputable peer-reviewed journal. The researchers used a randomized design, which reduces bias. However, this is animal research, so results may not directly translate to humans. The study measured multiple relevant markers of kidney health, which strengthens confidence in the findings. The relatively short treatment period (15 days of dapagliflozin) may not reflect long-term effects in humans taking these medications for years.

What the Results Show

Rats receiving both tenofovir and dapagliflozin showed restored kidney filtering ability compared to rats receiving tenofovir alone. The medication improved how well the kidneys could filter waste from the blood, a key measure of kidney health.

Dapagliflozin reduced harmful molecules called oxidative stress that accumulate when kidneys are damaged. Think of oxidative stress like rust forming on metal—dapagliflozin appeared to slow this damaging process. The drug also increased protective antioxidant molecules that naturally defend cells.

The medication reduced inflammation in the kidneys, which is a major driver of kidney damage. It did this by lowering inflammatory signaling molecules that trigger the immune system to attack kidney tissue.

Perhaps most importantly, dapagliflozin prevented kidney cells from dying. It increased protective proteins (Bcl-2) that keep cells alive and decreased death-promoting proteins (Bax, caspase-3) that trigger cell death.

The study found that dapagliflozin worked through specific cellular pathways, particularly one called SIRT1/Nrf2/HO-1. This pathway acts like a master switch for cellular protection. The drug also improved the function of mitochondria (the energy factories inside cells), which are particularly vulnerable to tenofovir damage. These findings suggest dapagliflozin protects kidneys through multiple mechanisms, not just one pathway.

Previous research has shown that tenofovir causes kidney damage through oxidative stress and inflammation. This study confirms those mechanisms and adds new evidence that dapagliflozin—already known to have kidney-protective effects in diabetes—may work through similar protective pathways. The findings align with growing recognition that SGLT2 inhibitors (the drug class dapagliflozin belongs to) have benefits beyond blood sugar control, particularly for organ protection.

This research was conducted in rats, not humans, so results may not directly apply to HIV patients. The study only lasted 45 days, while HIV patients take these medications for years or decades, so long-term effects are unknown. The study didn’t test different doses of dapagliflozin to find the optimal amount. It also didn’t examine potential interactions with other medications HIV patients commonly take. Finally, the study measured kidney markers but didn’t assess whether the protection would prevent actual kidney disease progression in living patients.

The Bottom Line

This research suggests dapagliflozin may help protect kidneys in people taking tenofovir, but the evidence is preliminary (animal studies only). Current recommendation: If you take tenofovir, discuss kidney health monitoring with your HIV specialist. Do not start dapagliflozin specifically for kidney protection without medical guidance, as human studies are needed first. Your doctor may already monitor your kidney function through regular blood tests—continue these as recommended.

This research is most relevant to HIV patients taking tenofovir who are concerned about kidney health. It may also interest people with diabetes taking dapagliflozin who want to understand their medication’s broader benefits. Healthcare providers treating HIV patients should note this emerging evidence for future clinical trial design. People without kidney concerns or those not taking these medications don’t need to act on this information currently.

In animal studies, protective effects appeared within 15 days of treatment. However, human kidneys respond differently than rat kidneys, and benefits may take weeks to months to appear. If human studies eventually confirm these findings, it would likely take several months of consistent treatment to see measurable improvements in kidney function tests.

Want to Apply This Research?

  • If your doctor prescribes dapagliflozin, track your kidney function test results (creatinine and eGFR values) every 3 months. Log these values in the app to visualize trends over time and share with your healthcare provider.
  • Work with your healthcare provider to establish a kidney health monitoring schedule. Set app reminders for scheduled blood work appointments and medication refills. Log any symptoms like changes in urination patterns, swelling, or fatigue that might indicate kidney issues.
  • Create a long-term tracking dashboard showing kidney function trends over 6-12 months. Compare your results to your baseline values and discuss any changes with your doctor. If taking both tenofovir and dapagliflozin, note any changes in energy levels, blood sugar, or urination patterns alongside your kidney function tests.

This research is preliminary animal-based evidence and should not be used to make treatment decisions. Tenofovir is an important HIV medication, and any changes to your antiretroviral regimen must be discussed with your HIV specialist. Do not start or stop dapagliflozin based on this study. If you take tenofovir, continue regular kidney function monitoring as recommended by your healthcare provider. This article is for educational purposes and does not replace professional medical advice.