Reduction in Albuminuria with Dapagliflozin Exhibits Substantial Interindividual Variability: A Real-World Study...

Area of Science:

• Nephrology
• Endocrinology
• Pharmacology

Background:

• The albuminuria-lowering effect of dapagliflozin exhibits interindividual variability.
• Understanding factors influencing this response is crucial for optimizing T2DKD management.

Purpose of the Study:

• To assess variability in dapagliflozin's albuminuria-lowering effect.
• To identify factors associated with patient response to dapagliflozin in T2DKD.

Main Methods:

• Retrospective observational cohort study of 10,860 T2DKD patients treated with dapagliflozin for ≥3 months.
• Categorized patients into responders (>30% UACR reduction) and non-responders.
• Used logistic regression and ROC analysis to identify influencing factors and assess predictive ability.

Main Results:

• 41.32% of patients were non-responders to dapagliflozin.
• Longer T2DM duration, higher baseline HbA1c, SBP, and UACR were associated with response.
• ROC analysis showed limited discriminative ability for these factors (AUC range: 0.508-0.646).

Conclusions:

• Significant interindividual variability exists in dapagliflozin's albuminuria-lowering effect in Chinese T2DKD patients.
• While T2DM duration, baseline HbA1c, SBP, and UACR are associated factors, their predictive value is insufficient for clinical application.