A pre-specified analysis of the dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) randomized controlled trial on the incidence of abrupt declines in kidney function

Kidney InternationalHeerspink HJL, Cherney D, Postmus D, et al. | September 24, 2021


Treatment with dapagliflozin in patients with chronic kidney disease (CKD) and substantial albuminuria was shown to confer a reduction in the risk of abrupt declines in kidney function.

  • This is a pre-specified analysis of DAPA-CKD (Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease, a randomized, double-blind, placebo-controlled trial with a median follow-up of 2.4 years).

  • Adults with CKD (urinary albumin-to-creatinine ratio 200–5000 mg/g and estimated glomerular filtration rate 25–75 mL/min/1.73m 2 ) were randomly assigned to dapagliflozin 10 mg/day matched to placebo (2152 persons each).

  • Serum creatinine doubling happened in 63 (2.9%) and 91 (4.2%) participants in the dapagliflozin and placebo groups, respectively (hazard ratio 0.68).

  • No heterogeneity was evident in the impact of dapagliflozin on abrupt reductions in renal function based on baseline subgroups.

  • In dapagliflozin and placebo groups, 52 (2.5%) and 69 (3.2%) participants suffered acute kidney injury-related serious adverse events, respectively (0.77).

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