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Kidney Week

Abstract: PO2365

Effects of Dapagliflozin in Patients with CKD and Albuminuria, with and Without Diabetes, by Use and Non-Use of Cardiovascular Medications: DAPA-CKD Trial

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Correa-Rotter, Ricardo, The National Medical Science and Nutrition Institute Salvador Zubiran, Mexico City, Mexico
  • Chertow, Glenn Matthew, Stanford University School of Medicine, Stanford, California, United States
  • Mark, Patrick B., University of Glasgow, Glasgow, Glasgow, United Kingdom
  • Nowicki, Michal P., Medical University of Lódz, Lódz, Poland
  • Vart, Priya, University Medical Center Groningen, Groningen, Netherlands
  • Jongs, Niels, University Medical Center Groningen, Groningen, Netherlands
  • Langkilde, Anna Maria, AstraZeneca, Gothenburg, Sweden
  • McMurray, John, University of Glasgow, Glasgow, Glasgow, United Kingdom
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Sjostrom, David, AstraZeneca, Gothenburg, Sweden
  • Stefansson, Bergur V., AstraZeneca, Gothenburg, Sweden
  • Toto, Robert D., UT Southwestern Medical Center, Dallas, Texas, United States
  • Wheeler, David C., University College London, London, London, United Kingdom
  • L Heerspink, Hiddo Jan, University Medical Center Groningen, Groningen, Netherlands
Background

The DAPA-CKD trial (NCT03036150) demonstrated that dapagliflozin reduced the risk of kidney and cardiovascular (CV) events in patients with chronic kidney disease (CKD) and albuminuria with and without type 2 diabetes. We aimed to determine whether baseline CV medications modified dapagliflozin treatment effect.

Methods

We randomized 4304 adults with baseline eGFR 25–75 mL/min/1.73m2 and urinary albumin-to-creatinine ratio 200–5000 mg/g to either dapagliflozin 10 mg or placebo once daily. The primary endpoint was a composite of ≥50% estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, and kidney or CV death. Here we categorized patients according to baseline CV medication use.

Results

Patients were required by protocol to receive a stable dose of a renin-angiotensin system inhibitor. The figure shows the effect of dapagliflozin compared with placebo, according to use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (97.0%), calcium channel blockers (50.7%), beta-blockers (39.0%), diuretics (43.7%), antithrombotic (47.4%) and lipid-lowering (69.4%) agents. The benefit of dapagliflozin was consistent across all background treatment subgroups, and findings were similar for pre-specified secondary outcomes (composite kidney endpoint, composite CV endpoint, and all-cause mortality).

Conclusion

The beneficial effects of dapagliflozin on kidney and CV endpoints in patients with CKD and albuminuria were evident among patients treated and not treated with a variety of CV medications.

Funding

  • Commercial Support