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Dapagliflozin & Hospitalizations in Patients With Chronic Kidney Disease

In patients with chronic kidney disease (CKD) with and without diabetes, dapagliflozin reduced the risk of hospitalization for any cause, according to a post hoc analysis of the DAPA-CKD (Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease) trial. “These findings highlight additional benefits of dapagliflozin beyond those seen for cardiovascular and kidney events, all-cause and cause-specific mortality, [estimated glomerular filtration rate (eGFR)] slope, and albuminuria and should be considered when evaluating the totality of evidence favoring provision of dapagliflozin to patients with CKD,” the authors conclude.

In the 21-country study, participants were ambulatory adults with eGFRs of 25 to 75 mL/min/1.73 m2 and urinary albumin–creatinine ratio of 200 to 5000 mg/g, with and without type 2 diabetes. Patients were randomized to dapagliflozin 10 mg once daily or placebo, with these results: “The study included 4304 patients (mean age, 61.8 years; 33.1% women). During a median follow-up of 2.4 years, 2072 hospitalizations were reported among 1224 (28.4%) participants. Compared with placebo, dapagliflozin reduced risk for a first hospitalization (hazard ratio, 0.84 [95% CI, 0.75 to 0.94]) and all hospitalizations or death (rate ratio, 0.79 [CI, 0.70 to 0.89]). There was no evidence that the effects of dapagliflozin on first and all hospitalizations varied by baseline presence of type 2 diabetes (P for interaction = 0.60 for each). Compared with placebo, dapagliflozin reduced the rate of admissions due to cardiac disorders, renal and urinary disorders, metabolism and nutrition disorders, and neoplasms.”

Summary for Patients available.

Source: Annals of Internal Medicine