echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Endocrine System > Lancet Diabetes Endocrinol: The effect of dapagliflozin on urinary albumin excretion in patients with chronic kidney disease with and without type 2 diabetes

    Lancet Diabetes Endocrinol: The effect of dapagliflozin on urinary albumin excretion in patients with chronic kidney disease with and without type 2 diabetes

    • Last Update: 2021-11-11
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

         Proteinuria and kidney failure in patients with chronic kidney disease, heart vascular events a recognized risk markers
    .
    Various drug interventions, including renin-angiotensin system inhibitors, SGLT2 inhibitors and glucagon-like peptide 1 receptor agonists, can reduce proteinuria

    .
    A meta-analysis of clinical trials has shown that early reduction of proteinuria is associated with a lower risk of renal failure, and supports the use of proteinuria as a biomarker of renal failure nephropathy
    .

         Proteinuria and kidney failure in patients with chronic kidney disease, heart vascular events a recognized risk markers
    .
    Various drug interventions, including renin-angiotensin system inhibitors, SGLT2 inhibitors and glucagon-like peptide 1 receptor agonists, can reduce proteinuria

    .
    A meta-analysis of clinical trials has shown that early reduction of proteinuria is associated with a lower risk of renal failure, and supports the use of proteinuria as a biomarker of renal failure nephropathy
    .
    Heart vascular events meta-analysis of clinical trials show that reducing proteinuria associated with a lower risk of kidney failure early, support the use of proteinuria as a biomarker of kidney failure kidney disease
    .

         SGLT2 inhibitors were originally developed as oral hypoglycemic agents for patients with type 2 diabetes and are not recommended for patients with chronic kidney disease because it is estimated that patients with low glomerular filtration rate (EGFR) have lower blood glucose efficiency
    .
    However,
    clinical trials have shown that SGLT2 inhibitors can reduce proteinuria in patients with type 2 diabetes and chronic kidney disease
    .
    These findings have aroused interest in studying the effects of SGLT2 inhibitors on long-term renal outcomes

    .
    The CRENTICS trial showed that dapagliflozin reduces the risk of clinically important renal and cardiovascular endpoints in patients with type 2 diabetes and chronic kidney disease

    .
    The Dapagliflozin and
    Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial extended these findings to patients with chronic kidney disease with and without type 2 diabetes, showing patients with progressive chronic kidney disease, cardiovascular death or heart failure hospitalization The rate and all-cause mortality were significantly reduced
    .

         SGLT2 inhibitors were originally developed as oral hypoglycemic agents for patients with type 2 diabetes and are not recommended for patients with chronic kidney disease because it is estimated that patients with low glomerular filtration rate (EGFR) have lower blood glucose efficiency
    .
    However,
    clinical trials have shown that SGLT2 inhibitors can reduce proteinuria in patients with type 2 diabetes and chronic kidney disease
    .
    These findings have aroused interest in studying the effects of SGLT2 inhibitors on long-term renal outcomes

    .
    The CRENTICS trial showed that dapagliflozin reduces the risk of clinically important renal and cardiovascular endpoints in patients with type 2 diabetes and chronic kidney disease

    .
    The Dapagliflozin and
    Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial extended these findings to patients with chronic kidney disease with and without type 2 diabetes, showing patients with progressive chronic kidney disease, cardiovascular death or heart failure hospitalization The rate and all-cause mortality were significantly reduced
    .
    Diabetes clinical trials have shown that SGLT2 inhibitors can reduce proteinuria in patients with type 2 diabetes and chronic kidney disease
    .
    These findings have aroused interest in studying the effects of SGLT2 inhibitors on long-term renal outcomes

    .
    The CRENTICS trial showed that dapagliflozin reduces the risk of clinically important renal and cardiovascular endpoints in patients with type 2 diabetes and chronic kidney disease

    .
    The Dapagliflozin and
    Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial extended these findings to patients with chronic kidney disease with and without type 2 diabetes, showing patients with progressive chronic kidney disease, cardiovascular death or heart failure hospitalization The rate and all-cause mortality were significantly reduced
    .
    prevention

          Recently, researchers have evaluated the effect of dapagliflozin on proteinuria in patients with chronic kidney disease with and without type 2 diabetes in the dapagliflozin and prevention of adverse outcomes of chronic kidney disease (DAPA-CKD) trial
    .

          Recently, researchers have evaluated the effect of dapagliflozin on proteinuria in patients with chronic kidney disease with and without type 2 diabetes in the dapagliflozin and prevention of adverse outcomes of chronic kidney disease (DAPA-CKD) trial
    .
          Recently, researchers have evaluated the effect of dapagliflozin on proteinuria in patients with chronic kidney disease with and without type 2 diabetes in the dapagliflozin and prevention of adverse outcomes of chronic kidney disease (DAPA-CKD) trial
    .

          DAPA-CKD is a multicenter, double-blind, placebo-controlled randomized trial conducted in 386 locations in 21 countries
    .
    If the patient has chronic kidney disease, it is defined as the estimated glomerular filtration rate (eGFR) between 25 ml/min per 1.
    73 m2 and 75 ml/min per 1.
    73 m2, with the urine albumin-creatinine ratio (UACR) in Between 200mg/g and 5000mg/g (22.
    6 to 565.
    6mg/mmol)

    .

          DAPA-CKD is a multicenter, double-blind, placebo-controlled randomized trial conducted in 386 locations in 21 countries
    .
    If the patient has chronic kidney disease, it is defined as the estimated glomerular filtration rate (eGFR) between 25 ml/min per 1.
    73 m2 and 75 ml/min per 1.
    73 m2, with the urine albumin-creatinine ratio (UACR) in Between 200mg/g and 5000mg/g (22.
    6 to 565.
    6mg/mmol)

    .
    A multi-center, double-blind, placebo-controlled randomized trial A multi-center, double-blind, placebo-controlled randomized trial A multi-center, double-blind, placebo-controlled randomized trial

         According to the quarantined fixed randomization schedule, participants were randomly assigned to reach Gligliflozin 10 mg (AstraZeneca; Gothenburg, Sweden), once a day or matching placebo, using a balance weight to ensure a ratio of approximately 1:1
    .
    The alteration of albuminuria is a pre-specified exploratory result of DAPA-CKD

    .
       

         According to the quarantined fixed randomization schedule, participants were randomly assigned to reach Gligliflozin 10 mg (AstraZeneca; Gothenburg, Sweden), once a day or matching placebo, using a balance weight to ensure a ratio of approximately 1:1
    .
    The alteration of albuminuria is a pre-specified exploratory result of DAPA-CKD

    .
       

         The regression of the UACR stage is defined as the transition from macroalbuminuria (≥300 mg/g) to microalbuminuria or normal albuminuria (<300 mg/g), the progression of the UACR stage (defined as the progression from less than 3000 mg) /g transition to 3000 mg/g or higher) is an additional discrete endpoint
    .
    The trial is registered with ClinicalTrials.
    gov, NCT03036150

    .

         The regression of the UACR stage is defined as the transition from macroalbuminuria (≥300 mg/g) to microalbuminuria or normal albuminuria (<300 mg/g), the progression of the UACR stage (defined as the progression from less than 3000 mg) /g transition to 3000 mg/g or higher) is an additional discrete endpoint
    .
    The trial is registered with ClinicalTrials.
    gov, NCT03036150

    .

    • During the period from February 2, 2017 to April 3, 2020, 4304 patients were recruited and randomly assigned to the parifluzine group (n=2152) or placebo group (n=2152)
      .
      The median UACR is 949 mg/g (IQR477~1885)

      .
    • Overall, dapagliflozin reduced the geometric mean UACR by 29.
      3% (95% CI-33·1 to -25·2; p<0.
      0001) compared with placebo.
      Compared with placebo, dapagliflozin net after treating type 2 diabetes and
      - 14.
      8% (
      - 22.
      9
      to - 5.
      9)
      of the geometric mean percentage change 35.
      1% (95% CI 39.
      4 to 30.
      6; P <from 0.
      0001)

      .
    • In patients without type 2 diabetes during follow-up (P<0.
      0001), in 3860 patients with baseline UACR ≥300 mg/g, dapagliflozin increased the likelihood of UACR regression (hazard ratio 1.
      81, 95% Confidence interval 1.
      60 to 2.
      05)

      .
    • In 3820 patients with a baseline UACR <3000 mg/g, dapagliflozin reduced the risk of progression of UACR staging (0.
      41, 0.
      32 to 0.
      52)

      .
      During dapagliflozin treatment, the large decrease in uric acid reduction rate on day 14 was significantly correlated with the attenuation of epidermal growth factor receptor decline in subsequent follow-ups (β change per log unit of uric acid reduction rate -3.
      06, 95% CI- 5.
      20 to -0.
      90; p=0.
      0056)
  • During the period from February 2, 2017 to April 3, 2020, 4304 patients were recruited and randomly assigned to the parifluzine group (n=2152) or placebo group (n=2152)
    .
    The median UACR is 949 mg/g (IQR477~1885)

    .
  • During the period from February 2, 2017 to April 3, 2020, 4304 patients were recruited and randomly assigned to the parifluzine group (n=2152) or placebo group (n=2152)
    .
    The median UACR is 949 mg/g (IQR477~1885)

    .
  • Overall, dapagliflozin reduced the geometric mean UACR by 29.
    3% (95% CI-33·1 to -25·2; p<0.
    0001) compared with placebo.
    Compared with placebo, dapagliflozin net after treating type 2 diabetes and
    - 14.
    8% (
    - 22.
    9
    to - 5.
    9)
    of the geometric mean percentage change 35.
    1% (95% CI 39.
    4 to 30.
    6; P <from 0.
    0001)

    .
  • Overall, dapagliflozin reduced the geometric mean UACR by 29.
    3% (95% CI-33·1 to -25·2; p<0.
    0001) compared with placebo.
    Compared with placebo, dapagliflozin net after treating type 2 diabetes and
    - 14.
    8% (
    - 22.
    9
    to - 5.
    9)
    of the geometric mean percentage change 35.
    1% (95% CI 39.
    4 to 30.
    6; P <from 0.
    0001)

    .
  • In patients without type 2 diabetes during follow-up (P<0.
    0001), in 3860 patients with baseline UACR ≥300 mg/g, dapagliflozin increased the likelihood of UACR regression (hazard ratio 1.
    81, 95% Confidence interval 1.
    60 to 2.
    05)

    .
  • In patients without type 2 diabetes during follow-up (P<0.
    0001), in 3860 patients with baseline UACR ≥300 mg/g, dapagliflozin increased the likelihood of UACR regression (hazard ratio 1.
    81, 95% Confidence interval 1.
    60 to 2.
    05)

    .
    In patients without type 2 diabetes during follow-up (P<0.
    0001), in 3860 patients with baseline UACR ≥300 mg/g, dapagliflozin increased the likelihood of UACR regression (hazard ratio 1.
    81, 95% Confidence interval 1.
    60 to 2.
    05)

    .
  • In 3820 patients with a baseline UACR <3000 mg/g, dapagliflozin reduced the risk of progression of UACR staging (0.
    41, 0.
    32 to 0.
    52)

    .
    During dapagliflozin treatment, the large decrease in uric acid reduction rate on day 14 was significantly correlated with the attenuation of epidermal growth factor receptor decline in subsequent follow-ups (β change per log unit of uric acid reduction rate -3.
    06, 95% CI- 5.
    20 to -0.
    90; p=0.
    0056)
  • In 3820 patients with a baseline UACR <3000 mg/g, dapagliflozin reduced the risk of progression of UACR staging (0.
    41, 0.
    32 to 0.
    52)

    .
    During dapagliflozin treatment, the large decrease in uric acid reduction rate on day 14 was significantly correlated with the attenuation of epidermal growth factor receptor decline in subsequent follow-ups (β change per log unit of uric acid reduction rate -3.
    06, 95% CI- p = 0.
    0056); 5.
    20 to -0.
    90
    dapagliflozin reduces the risk of progression stage UACR weakened during treatment dapagliflozin, a large reduction ratio decreased uric Day 14 follow-up and subsequently drop the epidermal growth factor receptor Significant correlation

          In patients with chronic kidney disease with and without type 2 diabetes, dapagliflozin significantly reduced proteinuria, and the relative reduction was greater in patients with type 2 diabetes
    .
    The effect of dapagliflozin on the clinical outcome of patients with type 2 diabetes and non-type 2 diabetes is similar, but the effect on UACR is different, suggesting that the partial protective effect of dapagliflozin on patients with chronic kidney disease may be different from reducing protein Urine pathway mediated

    .

          In patients with chronic kidney disease with and without type 2 diabetes, dapagliflozin significantly reduced proteinuria, and the relative reduction was greater in patients with type 2 diabetes
    .
    The effect of dapagliflozin on the clinical outcome of patients with type 2 diabetes and non-type 2 diabetes is similar, but the effect on UACR is different, suggesting that the partial protective effect of dapagliflozin on patients with chronic kidney disease may be different from reducing protein Urine pathway mediated

    .

    Literature source: Jongs N, Greene T, Chertow GM, 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.
    Lancet Diabetes Endocrinol.
    2021 ;9(11):755-766.
    doi:10.
    1016/S2213-8587(21)00243-6

    Literature source: Jongs N, Greene T, Chertow GM, 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.
    Lancet Diabetes Endocrinol.
    2021 ;9(11):755-766.
    doi:10.
    1016/S2213-8587(21)00243-6
    Jongs N, Greene T, Chertow GM, 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 Lancet Diabetes Endocrinol 2021; 9 (11):.
    .
    .
    755-766 doi: 10.
    1016 / S2213-8587 (21) 00243-6


    in this message
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.