Systolic blood pressure is associated with early and long-term changes in renal function in patients with...

We investigated factors associated with early and long-term changes in renal function after initiating dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, in patients with moderate-to-advanced chronic kidney disease (CKD).

A total of 124 patients (mean age, 70.0 ± 13.1 years; 93 men and 31 women) were retrospectively evaluated after 12 months of 10 mg dapagliflozin treatment based on changes in estimated glomerular filtration rate (eGFR). All patients had moderate-to-advanced CKD (mean eGFR: 36.8 ± 11.4 mL/min/1.73 m²; stage G3, n = 86; G4, n = 36; G5, n = 2). We used a multiple linear regression analysis to determine the independent factors associated with changes in eGFR during the administration of 12 months and first 1 month following dapagliflozin treatment.

Systolic blood pressure (SBP) (standard coefficient (β) =  - 0.499, probability (p) = 0.002) was independently correlated with change in eGFR during the administration of dapagliflozin. SBP (β =  - 0.265, p = 0.040), change in eGFR during the 12 months before dapagliflozin administration (β =  - 0.453, p < 0.001), and urinary protein-to-creatinine ratio (β =  - 0.282, p = 0.028) were independently correlated with the change in eGFR during the first 1 month of dapagliflozin administration.

SBP was associated with long-term change in eGFR after initiating dapagliflozin treatment in moderate-to-advanced CKD patients; SBP, urinary protein-to-creatinine ratio, and eGFR change before dapagliflozin administration were associated with early change in eGFR following dapagliflozin treatment in these patients.