Physicians' Academy for Cardiovascular Education

SGLT2i reduces risk of kidney failure, CV death or HF hospitalization, and all-cause mortality in CKD

News - Aug. 30, 2020

Dapagliflozin in Patients with Chronic Kidney Disease DAPA-CKD

Presented at the ESC congress 2020 by: Prof. Hiddo Heerspink, PhD, Groningen, The Netherlands

Introduction and methods

Patients with chronic kidney disease (CKD) are at high risk of adverse kidney and CV outcomes. The DAPA-CKD trial investigated the effect of SGLT2 inhibitor dapagliflozin, compared to placebo, on the risk of renal and CV events in CKD patients, with or without T2DM.

A total of 4304 patients (≥18 years of age) from 286 centers in 21 countries were included in the trial. Patients had an eGFR ≥25 and ≤75 mL/min/1.73m², urinary albumin to creatinine ratio between ≥200 mg/g and ≤5000 mg/g, and were already receiving a stable maximum tolerated dose of either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) as background therapy. Average age was 61.8 years, 66.9% were male and 67.5% had T2DM. Patients were randomized to receive either dapagliflozin 10 mg one daily or matching placebo.

The primary composite endpoint was worsening kidney function (defined as ≥50% sustained decline in eGFR or onset of end-stage kidney disease), or renal or CV death. The first secondary endpoint was a composite of worsening kidney function, or death from kidney failure. The second secondary endpoint was a composite of HF hospitalization or CV death. The third secondary endpoint was all-cause mortality.

The trial was stopped early due to overwhelming efficacy. This decision was made following a recommendation from an independent Data Monitoring Committee. The median follow-up was 2.4 years.

Main results


Dapagliflozin significantly reduced the risk of kidney failure, CV death or HF hospitalization, and all-cause mortality in patients with CKD, with and without T2DM, compared to placebo.

- Our reporting is based on the information provided at the ESC congress -

Watch a video by prof. Heerspink on this trial

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