Kidney Week

Abstract: PO0296

Excessive Decrease of Hematocrit After Discontinuation of Dapagliflozin

Session Information

• Anemia and Iron Management
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Wada, Yoshiharu, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Yoshiharu Wada,

• Hamamoto, Yoshiyuki, Kansai Electric Power Hospital, Osaka, Osaka, Japan

Yoshiyuki Hamamoto,

• Nakatani, Yoshihisa, Kindai University, Osakasayama, Osaka, Japan

Yoshihisa Nakatani,

• Honjo, Sachiko, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Sachiko Honjo,

• Keidai, Yamato, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Yamato Keidai,

• Seno, Yohei, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Yohei Seno,

• Iwasaki, Kanako, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Kanako Iwasaki,

• Iwasaki, Yorihiro, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Yorihiro Iwasaki,

• Fujikawa, Jun, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Jun Fujikawa,

• Kakita, Hiroko, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Hiroko Kakita,

• Hamasaki, Akihiro, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Osaka, Japan

Akihiro Hamasaki,

Background

Recently, sodium-glucose cotransporter 2 (SGLT-2) inhibitors were indicated to have hematopoietic effect, but it is still unclear how long the effect continues after discontinuation. In this study, we investigated changes in hematocrit, urinary gravity and HbA1c after discontinuation of SGLT-2 inhibitor in patients with type 2 diabetes.

Methods

A total of 8 patients (male: n=4, age: 54.4±11.9 [mean±SD] years, BMI: 27.1±3.4 kg/m², HbA1c: 9.2±1.2 %) with type 2 diabetes who were newly administered 5mg per day of dapagliflozin from March 2015 to September 2019 and discontinued the drug due to adverse events or side effects which did not require admission were retrospectively identified. Changes in HbA1c, hematocrit and urine specific gravity levels between before the administration and after the discontinuation of the drugs were evaluated.

Results

The drug was discontinued 8.4±6.6 months after administration due to non-benefit on glycemic control (n=4), polyuria (n=2), weight loss (n=1) and genital infection (n=1). HbA1c was not changed (-0.3±1.1 %; p=0.45) whereas urine specific gravity (0.014±0.009 g/mL; p<0.001) and hematocrit (1.63±1.99 %; p=0.04) were significantly increased at the time of discontinuation. Urine specific gravity (0.005±0.009 g/mL; p=0.12) and hematocrit (0.15±2.14 %; p=0.84) levels were returned to the levels of before drug administration 60 days after the discontinuation. After the 120 days of discontinuation, hematocrit was still continued to decrease below the level of baseline (-1.29±1.70 %; p=0.05) whereas urine specific gravity was not.

Conclusion

Our data demonstrate that the increased urine specific gravity and hematocrit return to original levels within 60 days after the discontinuation of dapagliflozin, and that hematocrit may continue to decrease below the original level even after.