Kidney Week

Abstract: PO0953

Renal, Cardiovascular (CV), and Safety Outcomes of Canagliflozin (CANA) According to Baseline Albuminuria: A CREDENCE Secondary Analysis

Session Information

• Diabetic Kidney Disease: Clinical - 1
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Bakris, George L., Department of Medicine, University of Chicago Medicine, Chicago, Illinois, United States

George L. Bakris,

• Jardine, Meg J., The George Institute for Global Health, Sydney, New South Wales, Australia

Meg J. Jardine,

• Zhou, Zien, The George Institute for Global Health, Sydney, Australia

Zien Zhou,

• L Heerspink, Hiddo Jan, The George Institute for Global Health, Sydney, Australia

Hiddo Jan L Heerspink,

• Li, Qiang, The George Institute for Global Health, Sydney, New South Wales, Australia

Qiang Li,

• Agarwal, Rajiv, Indiana University School of Medicine and VA Medical Center, Indianapolis, Indiana, United States

Rajiv Agarwal,

• Charytan, David M., Nephrology Division, NYU School of Medicine and NYU Langone Medical Center, New York, New York, United States

David M. Charytan,

• Oh, Richard, Janssen Research & Development, LLC, Raritan, New Jersey, United States

Richard Oh,

• Pollock, Carol A., Kolling Institute of Medical Research, Sydney Medical School, University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales, Australia

Carol A. Pollock,

• Wheeler, David C., Department of Medicine, University of Chicago Medicine, Chicago, United States

David C. Wheeler,

• de Zeeuw, Dick, Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands

Dick de Zeeuw,

• Zhang, Hong, Renal Division of Peking University First Hospital, Beijing, China

Hong Zhang,

• Zinman, Bernard, Lunenfeld-Tanenbaum Research Institute, Mt Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

Bernard Zinman,

• Mahaffey, Kenneth W., Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States

Kenneth W. Mahaffey,

• Perkovic, Vlado, Department of Medicine, University of Chicago Medicine, Chicago, Illinois, United States

Vlado Perkovic,

Background

Albuminuria is a risk factor for kidney disease progression and CV disease. We examined the relative and absolute effects of CANA by baseline albuminuria among CREDENCE participants.

Methods

CREDENCE was a double-blind, randomized study of 4401 participants with eGFR 30-<90mL/min/1.73m² and uACR >300-5000mg/g who demonstrated that CANA significantly reduced renal and CV outcomes, including the primary composite of end-stage kidney disease, doubling serum creatinine, or renal or CV death. We analyzed the effect of CANA on renal, CV, and safety outcomes by baseline uACR.

Results

At baseline, 2348 (53.4%), 1547 (35.2%), and 506 (11.5%) participants had uACR ≤1000, >1000-<3000, ≥3000mg/g. Higher uACR was associated with higher event rates (Figure). CANA reduced renal and CV endpoints, with no statistical variation by uACR (all p heterogeneity >0.17). CANA led to a greater absolute reduction in renal events in those with higher uACR (number needed to treat to prevent 1 episode of the primary composite: 22 and 8 for uACR >1000-<3000 and ≥3000mg/g). Rates of renal-related adverse events were lower with CANA, and the relative reduction was greater with higher uACR (p heterogeneity=0.003). CANA had no significant effect on acute kidney injury, volume depletion, hyperkalemia, urinary tract infections or hypoglycemia, with no differences by uACR (all p heterogeneity >0.12).

Conclusion

CANA safely reduces renal and CV events in people with type 2 diabetes and substantial albuminuria, with the greatest absolute renal benefit in those with uACR of 3000-5000mg/g.

Funding

• Commercial Support –