Dapagliflozin, advanced chronic kidney disease, and mortality: new insights from the DAPA-CKD trial
Abstract
This editorial refers to ‘Effects of dapagliflozin on mortality in patients with chronic kidney disease: a pre-specified analysis from the DAPA-CKD randomized controlled trial’†, by H.J.L. Heerspink et al., on page 1216. Effect of sodium–glucose co-transporter 2 (SGLT2) inhibitors in patients with chronic kidney disease (CKD) or heart failure with reduced ejection fraction (HFrEF). CV, cardiovascular; eGFR, estimated glomerular filtration rate; ESKD, end-stage kidney disease; HF, heart failure. *Data from DAPA-CKD5,6. #Data from a meta-analysis from DAPA-HF and EMPEROR-Reduced.8 Effect of sodium–glucose co-transporter 2 (SGLT2) inhibitors in patients with chronic kidney disease (CKD) or heart failure with reduced ejection fraction (HFrEF). CV, cardiovascular; eGFR, estimated glomerular filtration rate; ESKD, end-stage kidney disease; HF, heart failure. *Data from DAPA-CKD5,6. #Data from a meta-analysis from DAPA-HF and EMPEROR-Reduced.8 In the general population, both decreasing estimated glomerular filtration rate (eGFR) and increasing albuminuria are well-established predictors of overall mortality. The presence of diabetes mellitus further potentiates this relationship.1 In chronic kidney disease (CKD) stages 4–5, ∼50% of patients suffer from cardiovascular disease, and cardiovascular mortality accounts for ∼40–50% of all deaths in patients with CKD stage 4 as well as patients with end-stage kidney disease (ESKD), compared with 26% in controls with normal kidney…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 270 participants or records.
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