@article{46f47f16eceb43a2b2b993be7431f9dc,
title = "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",
abstract = "This pre-specified analysis of DAPA-CKD assessed the impact of sodium-glucose cotransporter 2 inhibition on abrupt declines in kidney function in high-risk patients based on having chronic kidney disease (CKD) and substantial albuminuria. DAPA-CKD was a randomized, double-blind, placebo-controlled trial that had 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/1.73m2) were randomized to dapagliflozin 10 mg/day matched to placebo (2152 individuals each). An abrupt decline in kidney function was defined as a pre-specified endpoint of doubling of serum creatinine between two subsequent study visits. We also assessed a post-hoc analysis of investigator-reported acute kidney injury–related serious adverse events. Doubling of serum creatinine between two subsequent visits (median time-interval 100 days) occurred in 63 (2.9%) and 91 (4.2%) participants in the dapagliflozin and placebo groups, respectively (hazard ratio 0.68 [95% confidence interval 0.49, 0.94]). Accounting for the competing risk of mortality did not alter our findings. There was no heterogeneity in the effect of dapagliflozin on abrupt declines in kidney function based on baseline subgroups. Acute kidney injury–related serious adverse events were not significantly different and occurred in 52 (2.5%) and 69 (3.2%) participants in the dapagliflozin and placebo groups, respectively (0.77 [0.54, 1.10]). Thus, in patients with CKD and substantial albuminuria, dapagliflozin reduced the risk of abrupt declines in kidney function.",
keywords = "SGLT2 inhibitors, acute kidney injury, chronic kidney disease, dapagliflozin",
author = "{DAPA-CKD Trial Committees and Investigators} and Heerspink, {Hiddo J.L.} and David Cherney and Douwe Postmus and Stef{\'a}nsson, {Bergur V.} and Chertow, {Glenn M.} and Dwyer, {Jamie P.} and Tom Greene and Mikhail Kosiborod and Langkilde, {Anna Maria} and McMurray, {John J.V.} and Ricardo Correa-Rotter and Peter Rossing and Sj{\"o}str{\"o}m, {C. David} and Toto, {Robert D.} and Wheeler, {David C.} and Hou, {Fan Fan} and Robert Toto and Bergur Stefansson and Maffei, {L. E.} and P. Raffaele and Solis, {S. E.} and Arias, {C. A.} and D. Aizenberg and C. Luquez and C. Zaidman and N. Cluigt and M. Mayer and A. Alvarisqueta and A. Wassermann and R. Maldonado and J. Bittar and M. Maurich and Gaite, {L. E.} and N. Garcia and L. Sivak and Ramallo, {P. O.} and Santos, {J. C.} and {Garcia Duran}, R. and Oddino, {J. A.} and A. Maranon and Maia, {L. N.} and Avila, {D. D.} and Barros, {E. J.G.} and Vidotti, {M. H.} and D. Panarotto and Noronha, {I. D.L.} and Turatti, {L. A.A.} and L. Deboni and Canziani, {M. E.} and Riella, {M. C.} and Bacci, {M. R.} and Paschoalin, {R. P.} and Franco, {R. J.} and Goldani, {J. C.} and E. St-Amour and Steele, {A. W.} and R. Goldenberg and S. Pandeya and H. Bajaj and Kaiser, {S. M.} and Conway, {J. R.} and Chow, {S. S.} and G. Bailey and J. Lafrance and J. Winterstein and S. Cournoyer and D. Gaudet and F. Madore and Houlden, {R. L.} and A. Dowell and M. Langlois and N. Muirhead and H. Khandwala and A. Levin and Y. Xue and L. Zuo and C. Hao and Z. Ni and C. Xing and N. Chen and Y. Dong and R. Zhou and X. Xiao and Y. Zou and C. Wang and B. Liu and Q. Chen and M. Lin and Q. Luo and D. Zhang and J. Wang and M. Chen and X. Wang and A. Zhong and J. Dong and C. Zhu and T. Yan and P. Luo and Y. Ren and P. Pai and D. Li and R. Zhang and J. Zhang and M. Xu and Y. Zhuang and Y. Kong and X. Yao and X. Peng and Persson, {F. I.} and Hansen, {T. K.} and R. Borg and {Pedersen Bjergaard}, U. and D. Hansen and M. Hornum and H. Haller and G. Klausmann and D. Tschope and T. Kruger and P. Gross and C. Hugo and N. Obermuller and L. Rose and P. Mertens and H. Zeller-Stefan and A. Fritsche and L. Renders and J. Muller and K. Budde and B. Schroppel and I. Wittmann and P. Voros and M. Dudas and Tabak, {G. A.} and R. Kirschner and A. Letoha and I. Balku and Z. Hermanyi and G. Zakar and I. Mezei and Nagy, {G. G.} and J. Lippai and A. Nemeth and D. Khullar and Gowdaiah, {P. K.} and {Fernando Mervin}, E. and Rao, {V. A.} and D. Dewan and K. Goplani and Maddi, {V. S.K.} and Vyawahare, {M. S.} and Pulichikkat, {R. K.} and R. Pandey and Sonkar, {S. K.} and Gupta, {V. K.} and S. Agarwal and Asirvatham, {A. J.} and A. Ignatius and S. Chaubey and S. Melemadathil and H. Alva and Y. Kadam and H. Shimizu and A. Sueyoshi and H. Takeoka and Y. Abe and T. Imai and Y. Onishi and Y. Fujita and Y. Tokita and M. Oura and Y. Makita and A. Idogaki and R. Koyama and H. Kikuchi and N. Kashihara and T. Hayashi and Y. Ando and T. Tanaka and M. Shimizu and S. Hidaka and T. Gohda and K. Tamura and M. Abe and Y. Kamijo and T. Imasawa and Y. Takahashi and M. Nakayama and M. Tomita and F. Hirano and Y. Fukushima and A. Kiyosue and S. Kurioka and E. Imai and K. Kitagawa and M. Waki and J. Wada and K. Uehara and H. Iwatani and K. Ota and S. Shibazaki",
note = "Publisher Copyright: {\textcopyright} 2021 International Society of Nephrology",
year = "2022",
month = jan,
day = "1",
doi = "10.1016/j.kint.2021.09.005",
language = "English",
volume = "101",
pages = "174--184",
journal = "Kidney International",
issn = "0085-2538",
number = "1",
}