Kidney Week

Abstract: TH-PO059

SGLT2 Inhibitor Dapagliflozin Reduces Biomarkers of Tubular Injury in Patients with Acute Heart Failure

Session Information

• AKI: Liver Disease, Nephrotoxicity, Novel Therapeutics
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Wattanakul, Jananya, Bhumibol Adulyadej Hospital, Bangkok, Bangkok, Thailand

Jananya Wattanakul,

• Gojaseni, Pongsathorn, Bhumibol Adulyadej Hospital, Bangkok, Bangkok, Thailand

Pongsathorn Gojaseni,

• Chittinandana, Anutra, Bhumibol Adulyadej Hospital, Bangkok, Bangkok, Thailand

Anutra Chittinandana,

Background

Sodium-glucose co-transporter 2 (SGLT2) inhibitors improve renal and cardiovascular outcomes in heart failure patients, and there is growing evidence that it would decrease the risk of acute kidney injury (AKI). The aim of this study was to assess the effect of SGLT2 inhibitor on biomarkers of tubular injury in patients with acute heart failure (AHF).

Methods

Patients who hospitalized for AHF were randomized to dapagliflozin added to standard therapy or control group for 28 days. The primary outcome was the change of urinary [TIMP-2] x [IGFBP7] by NephroCheck^® from baseline. The secondary outcome was incidence of AKI, the change of serum creatinine from baseline, adverse events and 28-day mortality.

Results

A total of 32 patients underwent randomization. Compared with control group, dapagliflozin group significantly reduced urinary [TIMP-2] x [IGFBP7] after 7 days [dapagliflozin: -0.03 ± 0.37 (ng/mL)²/1000; control: +0.4 ± 0.50 (ng/mL)²/1000; P = 0.022] and continue this trend until the end of the study [dapagliflozin: -0.09 ± 0.79 (ng/mL)²/1000; control: +0.67 ± 0.91 (ng/mL)²/1000; P = 0.096] (Figure 1). In terms of clinical outcomes, dapagliflozin has demonstrated a trend towards decrease in AKI events compared with control (33.3% vs 46.2%; P = 0.513). The change of serum creatinine, adverse events and 28-day mortality showed no differences in both groups.

Conclusion

Initiation of SGLT2 inhibitors in patients with AHF significantly decrease the urinary AKI risk markers TIMP-2 and IGFBP7, that supported protective effect of SGLT2 inhibitor on renal tubular injury.

Funding

• Government Support – Non-U.S.