Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure
Why the study?
The study sought to investigate the effects of dapagliflozin in patients with chronic kidney disease, with and without heart failure.
Does dapagliflozin 10 mg daily reduce the composite of ≥50% decline in estimated glomerular filtration rate, end-stage kidney disease, or kidney/cardiovascular death in patients with chronic kidney disease with and without heart failure?
Population
4,304 CKD patients with and without type 2 diabetes, including 468 with heart failure
Comparison
Dapagliflozin 10 mg daily vs placebo
Design
Prespecified analysis of a randomized trial
Authors
Discussion
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Member takes
Implication
Dapagliflozin benefits CKD patients irrespective of HF status; confirms consistent efficacy across subgroups in this RCT.
Key Points
- The aim is to evaluate dapagliflozin's effects on kidney and cardiovascular outcomes in CKD patients, considering their heart failure status.
- 4,304 participants were randomized to either dapagliflozin 10 mg daily or placebo.
- Primary endpoint: ≥50% decline in estimated glomerular filtration rate, end-stage kidney disease, or kidney/cardiovascular death.
- Analysis examined outcomes based on heart failure history.
- Dapagliflozin reduced the risk of the primary outcome in HF (HR: 0.58, 95% CI: 0.37-0.91) and non-HF patients (HR: 0.62, 95% CI: 0.51-0.75).
- Cardiovascular death/HF hospitalization and all-cause death rates also showed reductions with dapagliflozin in both groups.
- Adverse event rates were low and similar in both patient cohorts.
Structured PICO
Does dapagliflozin 10 mg daily reduce the composite of ≥50% decline in estimated glomerular filtration rate, end-stage kidney disease, or kidney/cardiovascular death in patients with chronic kidney disease with and without heart failure?
P
Population
4,304 participants with chronic kidney disease (CKD), with and without type 2 diabetes, including 468 (11%) with heart failure at baseline.
I
Intervention
Dapagliflozin 10 mg daily
C
Comparator
Placebo
O
Outcome
Composite of ≥50% decline in estimated glomerular filtration rate, end-stage kidney disease, or kidney/cardiovascular deathcomposite
Dapagliflozin significantly reduces the risk of kidney failure, cardiovascular death, and heart failure hospitalization in patients with chronic kidney disease, regardless of baseline heart failure status.
Cite This Study
McMurray et al. (2021) studied this question.