data were available were included.Based on the median of estimated daily salt intake at baseline (eUNa), patients were divided into low-salt and high-salt groups.Systolic BP (SBP) after treatment, changes in the urinary protein-to-creatinine ratio (UPCR), and the rate of change in eGFR before and after treatment were compared between the two groups.Results: At baseline, SBP was 136.1 17.4mmHg, , median eGFR was 43.5 mL/min/1.73m 2 (interquartile range IQR 27.4-52.9),UPCR was 0.75 g/gCr (0.32-1.76), and eUNa was 7.9 g (6.6-9.8).After treatment, SBP was 124.1 18.2 mmHg, and the change in UPCR was 0.60 (0.29-0.81); both changes were statistically significant.The decrease in SBP was greater in the high-salt group (-15.1 16.9 mmHg) than in the low-salt group (-3.3 15.5 mmHg, p = 0.04), and this difference remained significant even after adjusting for the presence or absence of hypertension (p < 0.05, two-way ANOVA).In contrast, there were no significant differences in the UPCR change rate (log UPCR change rate: -0.60 0.43 vs. -0.53 0.75, p = 0.79), or eGFR change rate before and after treatment (-1.2 15.0 mL/min/1.73m 2 /year vs. -2.1 14.9, p = 0.86).A similar analysis was performed using the urinary sodium/ potassium ratio (uNa/K), but no significant difference in BP reduction was observed.The BP-lowering effect of dapagliflozin depended on salt intake and was not correlated with uNa/K, suggesting that the antihypertensive mechanism is attributable to direct inhibition of tubular sodium reabsorption rather than indirect effects through RAS modulation.On the other hand, the reduction in urinary protein excretion appears to be largely attributable to the reduction of intraglomerular pressure rather than systemic BP lowering.These findings also suggest that dapagliflozin has a relatively weak effect in ameliorating residual renal risk after RAS inhibitor. Conclusion:In patients with high salt intake, the BP-lowering effect of dapagliflozin was greater, but this effect was not associated with enhanced renal protection.I have potential conflict of interest to disclose.honoraria from AstraZeneca, Bayer, Boehringer Ingelheim I did not use generative AI and AI-assisted technologies in the writing process.
Kushnirenko et al. (Wed,) studied this question.