ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: FR-OR133

The Dapagliflozin in Heart Failure with Reduced Ejection Fraction Trial (DAPA-HF): Outcomes in Patients with CKD and Effects on Renal Function

Session Information

  • High-Impact Clinical Trials
    November 08, 2019 | Location: Ballroom C, Walter E. Washington Convention Center
    Abstract Time: 02:30 PM - 02:45 PM

Category: CKD (Non-Dialysis)


  • Solomon, Scott D., Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Jhund, Pardeep, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
  • Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
  • Verma, Subodh, St. Michael's Hospital, Toronto, Ontario, Canada
  • Inzucchi, Silvio E., Yale University School of Medicine, New Haven, Connecticut, United States
  • Langkilde, Anna Maria, AstraZeneca , Gothenburg, Sweden
  • Martinez, Felipe, DAMIC Institute, Cordoba, Argentina
  • Bengtsson, Olof, Astrazeneca, Molndal, Sweden
  • Docherty, Kieran F, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
  • Køber, Lars, Rigshospitalet, Copenhagen, Denmark
  • Sjostrand, Mikaela, Astrazeneca, Molndal, Sweden
  • Sabatine, Marc S., TIMI Study Group, Boston, Massachusetts, United States
  • McMurray, John, University of Glasgow, Glasgow, United Kingdom

Group or Team Name

  • DAPA-HF Executive Committee

A substantial proportion of patients with heart failure and reduced ejection fraction (HFrEF) have or develop chronic kidney disease (CKD). SGLT-2 inhibitors have been shown to delay the progression of kidney disease and reduce the incidence of cardiac events in patients with type 2 diabetes (T2D) and CKD. Dapagliflozin (DAPA) was shown in the DAPA-HF Trial to reduce the primary composite outcome of a worsening heart failure event or cardiovascular death in patients with HFrEF, both with and without T2D


We randomized 4744 patients with NYHA class II-IV heart failure, LVEF ≦40%, elevation in natriuretic peptides and optimal background HFrEF therapy to DAPA 10mg qd or placebo (PBO). The primary outcome is described above. The prespecified secondary renal outcome was a sustained ≥50% reduction in eGFR, end-stage renal disease or death from renal causes. We also prespecified an analysis of the effect of DAPA, compared to PBO, in patients with and without CKD (eGFR <60 ml/min/1.73m2 at baseline).


Overall, 45% of patients had T2D and 55% did not. The baseline eGFR was 65.8 ± 19.4 ml/min/1.73m2 and 1926 (40.6%) patients had CKD. A worsening heart failure event or cardiovascular death (the primary end point) occurred in 386 patients (16.3%) in the DAPA group and 502 patients (21.2%) in the PBO group: hazard ratio [HR] 0.74; 95% confidence interval [CI], 0.65-0.85; P<0.001. DAPA reduced the primary outcome by a similar magnitude in patients with CKD (HR 0.72, 95%CI 0.59-0.86) and without CKD (HR 0.76, 95%CI 0.63, 0.92) - results to be shown at ASN. The composite renal endpoint was observed in 28 (1.2%) patients in the DAPA group vs 39 (1.6%) in the PBO arm (HR 0.71, 95% CI 0.44, 1.16). Renal serious adverse events and investigator reported acute kidney injury were significantly less common in the DAPA group. Additional results, including eGFR over-time, will be shown at the ASN annual meeting.


In this trial including HFrEF patients with and without T2D, DAPA reduced the composite of a worsening heart failure event or cardiovascular death, both in participants with CKD and in those without CKD. The absolute benefit in patients with CKD was substantial.


  • Commercial Support