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The reduction of proteinuria in patients with chronic kidney disease is associated with a lower risk of subsequent renal failure
.
The SGLT2 inhibitor dapagliflozin can significantly reduce proteinuria in patients with type 2 diabetes with normal or close to normal renal function
.
diabetes
The DAPA-CKD study is a multi-center, double-blind, placebo-controlled randomized trial conducted in 386 locations in 21 countries to evaluate the effect of dapagliflozin on proteinuria in patients with chronic kidney disease with type 2 diabetes Impact
.
Recruited patients with confirmed chronic kidney disease (eGFR=25-75 mL/min·1.
73 m2, urinary albumin-creatinine ratio (UACR)=200~5000 mg/g[22.
6~565.
6 mg/mmol]), and randomly divided them into daglie Net group (dapagliflozin 10 mg/day) or placebo group
.
The intended exploratory endpoint is a change in proteinuria
.
From February 2, 2017 to April 3, 2020, a total of 4304 patients were recruited and randomly assigned to the dapagliflozin group (n=2152) or placebo group (n=2152)
.
The median UACR was 949 mg/g (range 477~1885)
.
Compared with placebo, dapagliflozin patients can UACR geometric mean of 29.
Compared with placebo, the effect of dapagliflozin on geometric mean UACR
Compared with placebo, the effect of dapagliflozin on geometric mean UACRIn 3860 patients with a baseline UACR ≥ 300 mg/g, dapagliflozin increased the possibility of UACR staging (from large proteinuria to microalbuminuria or no proteinuria) (hazard ratio [HR] 1.
81 , 95% CI 1.
60~2.
05)
.
In 3820 patients with a baseline UACR <300 mg/g, dapagliflozin reduced the risk of UACR stage progression (HR 0.
41, 0.
In 3860 patients with a baseline UACR ≥ 300 mg/g, dapagliflozin increased the likelihood of UACR staging (from massive proteinuria to microalbuminuria or no proteinuria) at baseline UACR ≥ 300 mg/g.
In patients with chronic kidney disease with or without type 2 diabetes, dapagliflozin can still significantly reduce proteinuria, and the relative reduction in patients with type 2 diabetes is even greater in patients with type 2 diabetes with or without chronic kidney disease.
Original source:
Niels Jongs, et al.
Effect of dapagliflozin on urinary albumin excretion in patients with chronic kidney disease with and without type 2 diabetes: a prespecified analysis from the DAPA-CKD trial in this message