Why the study?
It was important to determine whether the treatment-induced early eGFR decline with dapagliflozin, spironolactone, or their combination reflects kidney injury or merely hemodynamic changes.
Does the combination of dapagliflozin and spironolactone cause true kidney injury compared to either drug alone in patients with HFmr/pEF?
Population
Patients with HFpEF
Comparison
Dapagliflozin/spironolactone combination vs dapagliflozin or spironolactone alone
Follow-up
12 weeks
Authors
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Transient eGFR dips warrant continued monitoring without discontinuation in HFmr/pEF; leaves open long-term renal impact in prospective trials.
Does the combination of dapagliflozin and spironolactone cause true kidney injury compared to either drug alone in patients with HFmr/pEF?
In patients with HFmr/pEF, the combination of dapagliflozin and spironolactone reduces blood pressure and eGFR more than either drug alone at 12 weeks, prompting investigation into whether this represents true kidney injury or transient hemodynamic changes.
Ferreira et al. (2026) studied this question.