Abstract: Objective To explore the effects of dapagliflozin combined with irbesartan on random urine microalbumin to creatinine ratio(ACR), glomerular filtration rate（eGFR）, and serum cystatin C(Cys C) levels in patients with diabetic nephropathy. 
Methods A total of 72 patients with diabetic nephropathy admitted to our hospital were selected as the research subjects. The patients were divided into a control group(35 cases) and an observation group(37 cases) by random number method. The control group was treated with irbesartan on the basis of conventional treatment, and the observation group was treated with dapagliflozin on the basis of the control group. The differences in urinary ACR, eGFR, CysC and blood lipid indexes of the two groups of patients before and after treatment were analyzed, and the incidence of adverse reactions after treatment in two groups were compared. 
Results The total effective rate of treatment in the observation group was 89.19%(33/37), which was significantly higher than 68.57%(24/35) in the control group. There was a statistical difference between the two(P＜0.05). After 2 months of treatment,  total cholesterol(TC), triglyceride(TG),  low density lipoprotein cholesterol(LDL-C) and other blood lipid indicators in the two groups decreased significantly, and the degree of blood lipid decrease in the observation group was significantly higher than that of the control group, the difference was statistically significant(P＜0.05). The urinary ACR and Cys C levels of the two groups of patients decreased significantly, and the eGFR level increased significantly, and the changes of various indicators in the observation group were significantly higher than those of the control group, the difference was statistically significant(P＜0.05). One case(2.70%) in the observation group had an end-point event, which was significantly less than the 6 cases(17.14%) in the control group. The difference was statistically significant(P＜0.05). 
Conclusion The treatment of DN with dapagliflozin combined with irbesartan can effectively improve the clinical efficacy and glomerular filtration rate of the patient, reduce the patient′s blood lipid level, the ratio of urine microalbumin to urine creatinine and serum cystatin C, and protect the patient renal function, reduce the incidence of adverse events after treatment, and provide favorable conditions for the prognosis of patients.

Key words: diabetic nephropathies, dapagliflozin, irbesartan