THE IMPACT OF DAPAGLIFLOZIN ON URINE ALBUMIN EXCRETION IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND TYPE 2 DIABETES: A PLANNED ANALYSIS FROM THE DAPA-CKD TRIAL

Background: Chronic kidney disease (CKD) has a large worldwide health impact, especially when combined with type 2 diabetes. The DAPA-CKD study looked at how dapagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, affected urine albumin excretion for individuals having CKD who also had type 2 diabetes.

Aim: The primary goal of our prespecified analysis was to evaluate specific effects of dapagliflozin on urinary albumin excretion in a subpopulation of patients with CKD, elucidating its potential benefits in both diabetic and non-diabetic individuals.

Methods: The DAPA-CKD trial was the multicenter, randomized, double-blind study involving patients having CKD, with and without type-2 diabetes. The trial included a prespecified subgroup analysis focusing on urinary albumin excretion. Individuals were randomly randomized to receive dapagliflozin or a placebo, and the effect on urine albumin excretion was measured over a set time period.

Results: The study found a substantial reduction in urine albumin excretion in participants treated with dapagliflozin compared to the placebo group, regardless of type 2 diabetes. Subgroup analyses further explored variations in response among diabetic and non-diabetic individuals, providing valuable insights into the differential effects of dapagliflozin in these subpopulations.

Conclusion: Dapagliflozin demonstrates a promising therapeutic effect in reducing urinary albumin excretion in patients having CKD, irrespective of their diabetic status. Those results underscore potential of SGLT2 inhibitors as a valuable addition to the treatment armamentarium for individuals with CKD, addressing a critical aspect of renal damage. Further research is warranted to elucidate the long-term implications and mechanisms underlying these observed effects.

Keywords: Dapagliflozin, chronic kidney disease, type-2 diabetes, urinary albumin excretion, SGLT2 inhibitor, DAPA-CKD trial.