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Updated: Apr 14, 2026

A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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Design, rationale, and baseline characteristics of the dapagliflozin in haemodialysis (DAPA-HD) trial

Thomas A Zelniker1, Christopher Paschen2, Christopher Mann1

  • 1Division of Cardiology, Department of Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

ESC Heart Failure
|April 12, 2026
PubMed

Insights

The Dapagliflozin in Hemodialysis (DAPA-HD) trial investigates cardiovascular effects of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in hemodialysis patients. This study addresses a critical gap in understanding SGLT2i benefits for kidney failure patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Sodium-glucose co-transporter 2 inhibitors (SGLT2i) show cardiovascular benefits in chronic kidney disease, but efficacy in end-stage kidney disease patients on hemodialysis is unproven.
  • Mechanisms of SGLT2i cardiovascular benefits and their dependence on residual kidney function are not fully understood.

Purpose of the Study:

  • To evaluate the cardiovascular effects of dapagliflozin in patients with kidney failure undergoing maintenance hemodialysis.
  • To investigate whether residual kidney function influences the cardiovascular benefits of dapagliflozin.

Main Methods:

  • The Dapagliflozin in Hemodialysis (DAPA-HD) trial is a randomized, double-blind, placebo-controlled study involving 220 hemodialysis patients.
  • Primary endpoint: change in left ventricular mass indexed to body surface area after six months.
  • Subgroup analysis based on residual urine output (>200 mL/24 hours vs. ≤200 mL/24 hours).

Main Results:

  • N/A - Trial results are pending.

Conclusions:

  • The DAPA-HD trial is the first to specifically assess dapagliflozin's cardiovascular and hemodynamic impact in hemodialysis patients.
  • Findings will clarify SGLT2i efficacy and potential benefits in the kidney failure population, with or without residual urine output.
Abstract

Keywords:
DapagliflozinDialysisKidney failureLeft ventricular hypertrophyRandomized controlled trialSGLT2i

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