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Short-Term Dapagliflozin Administration in Autosomal Dominant Polycystic Kidney Disease-A Retrospective Single-Arm

Fumiyuki Morioka1, Shinya Nakatani1, Hideki Uedono1

  • 1Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan.

Journal of Clinical Medicine
|October 14, 2023
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitors like dapagliflozin showed potential benefits for autosomal dominant polycystic kidney disease (ADPKD) risk factors. However, this study found dapagliflozin decreased estimated glomerular filtration rate and increased kidney volume in ADPKD patients.

Area of Science:

  • Nephrology
  • Pharmacology
  • Genetics

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by kidney cyst formation.
  • Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated renoprotective effects in other kidney diseases.
  • Patients with ADPKD were often excluded from clinical trials investigating SGLT2 inhibitors, limiting evidence for their use in this population.

Purpose of the Study:

  • To investigate the effects of dapagliflozin, an SGLT2 inhibitor, on height-adjusted kidney volume (htTKV) and estimated glomerular filtration rate (eGFR) in ADPKD patients.
  • To assess the short-term impact of dapagliflozin on key disease parameters in ADPKD.

Main Methods:

  • A retrospective, single-arm case series study involving 20 ADPKD patients.
  • Patients received dapagliflozin 10 mg/day for a period of 102 ± 20 days.
  • Measurements included htTKV and eGFR, with analysis of urinary phosphate changes.

Main Results:

  • A statistically significant decrease in eGFR from 47.9 to 40.8 mL/min/1.73 m² (p < 0.001) was observed.
  • A significant increase in htTKV from 599 to 617 mL/m (p = 0.002) was noted.
  • The annual increase rate of htTKV was promoted, and urinary phosphate changes correlated with htTKV changes (rs = 0.575, p = 0.020).

Conclusions:

  • Short-term administration of dapagliflozin in ADPKD patients resulted in decreased eGFR and increased htTKV.
  • The observed changes suggest a potential adverse effect of dapagliflozin on ADPKD progression.
  • Further interventional studies are required to confirm these findings and elucidate the role of dapagliflozin in ADPKD management.
Keywords:
autosomal dominant polycystic kidney diseasedapagliflozintotal kidney volume

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