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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Effect of Dapagliflozin on Clinical Outcomes in Patients With Chronic Kidney Disease, With and Without Cardiovascular
John J V McMurray1, David C Wheeler2,3, Bergur V Stefánsson4
1Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (J.J.V.M.).
Circulation
|November 13, 2020
Summary
Dapagliflozin significantly lowers the risk of kidney failure and cardiovascular events in patients with chronic kidney disease (CKD). This benefit was consistent regardless of a patient's prior cardiovascular disease history.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Chronic kidney disease (CKD) poses significant risks for end-stage renal disease (ESRD) and cardiovascular events.
- Dapagliflozin, an SGLT2 inhibitor, has shown promise in managing CKD.
- Understanding its efficacy in patients with and without pre-existing cardiovascular disease (CVD) is crucial.
Purpose of the Study:
- To evaluate the effect of dapagliflozin on cardiovascular and renal events in CKD patients.
- To assess the drug's efficacy in subgroups with and without a history of cardiovascular disease.
Main Methods:
- The DAPA-CKD trial randomized 4304 CKD participants to dapagliflozin or placebo.
- Primary endpoint: composite of sustained eGFR decline, ESRD, or kidney/cardiovascular death.
- Secondary endpoints included kidney composite outcomes, heart failure hospitalizations, cardiovascular death, and all-cause mortality.
Main Results:
- Patients with prior CVD (secondary prevention) were older, more likely male, and had higher BP and BMI.
- Dapagliflozin demonstrated similar risk reduction for the primary composite outcome in both primary (HR 0.61) and secondary (HR 0.61) prevention groups.
- Benefits on heart failure hospitalization/cardiovascular death and all-cause mortality were also consistent across subgroups.
Conclusions:
- Dapagliflozin effectively reduces the risk of kidney failure, cardiovascular death, and heart failure hospitalization in CKD patients.
- The benefits of dapagliflozin are independent of a patient's history of cardiovascular disease.
- Adverse event rates were low and comparable between treatment groups.
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