Dapagliflozin in peritoneal dialysis patients: a pilot study evaluating peritoneal membrane function

Area of Science:

• Nephrology
• Pharmacology
• Biochemistry

Background:

• Sodium-glucose cotransporter 2 (SGLT-2) inhibitors may delay peritoneal fibrosis and improve outcomes in patients undergoing peritoneal dialysis.
• Previous research suggests potential benefits of SGLT-2 inhibitors in managing fluid and toxin removal during peritoneal dialysis.

Purpose of the Study:

• To evaluate the effects of Dapagliflozin on peritoneal solute transfer rate.
• To assess Dapagliflozin's impact on reducing peritoneal glucose absorption and enhancing ultrafiltration in continuous ambulatory peritoneal dialysis (CAPD) patients.

Main Methods:

• A pilot pre-post interventional study involving 20 CAPD patients over one month.
• Participants had a PD vintage of at least six months and high/average high peritoneal transport status.
• The study assessed changes in peritoneal solute transport using the Peritoneal Equilibrium Test.

Main Results:

• Dapagliflozin treatment showed varied effects on the D4/D0 ratio, with increases in 13 patients and decreases in seven.
• Median D/P ratio changes were also mixed, with nine patients showing a decrease and 11 an increase.
• No statistically significant reduction in peritoneal glucose absorption was observed.

Conclusions:

• Dapagliflozin did not significantly reduce glucose absorption across the peritoneal membrane in this patient cohort.
• Associated non-significant findings included a slight increase in sodium dip and decreases in peritoneal VEGF and systemic IL-6.
• Larger-scale studies are necessary to confirm these preliminary findings and explore potential therapeutic roles.