Dapagliflozin in Active Lupus Nephritis

Inclusion Criteria:

* • Age 18-70 years, fulfilling 2012 SLICC or 2019 ACR/EULAR criteria for SLE, with biopsy-proven class III, IV and/or V LN

  * Active (new or relapsing) LN within the prior six months, with at least one of the following:

    * Kidney biopsy with activity index \>2 and/or
    * Active urinary sediment (\>5 RBCs, \>5 WBCs, or cellular casts)
  * Receiving standard-of-care immunosuppression regimen for active LN, including mycophenolate, cyclophosphamide, belimumab, azathioprine, a calcineurin inhibitor, and/or B cell depleting therapies
  * Recent or ongoing glucocorticoids use for active LN within the past 6 months
  * Receiving standard-of-care antimalarial therapy and RAAS blockade, unless contraindicated
  * Estimated ≥0.5 g/g 24 hr proteinuria or ≥0.3 mg/g 24 hr microalbuminuria at enrollment (on first morning urine)
  * Ability to given informed consent

Exclusion Criteria:

* GFR \< 25 ml/min/1.73m2

  * Acute kidney injury at study enrollment (\>50 percent rise in creatinine within 90 days)
  * Type I diabetes, underweight (BMI \<18.5), active malignancy, active infection, or recurrent genitourinary infections
  * For females: pregnancy, or desiring of pregnancy and not using contraception, or unable to use contraception
  * Current use of \>1mg/kg/day prednisone equivalent
  * Current or prior use of SGLT2 inhibitors or GLP-1 receptor agonists