Clinical Efficacy of Dapagliflozin in Cases of Advanced Renal Dysfunction in Chronic Kidney Disease.

Objective The present study investigated the various clinical effects of dapagliflozin in chronic kidney disease (CKD) and its efficacy in patients with advanced renal dysfunction. Methods A total of 94 CKD cases (non-diabetic, 58; diabetic, 36) were treated with dapagliflozin (10 mg) in an outpatient setting for 12 months. The estimated glomerular filtration rate (eGFR) was measured during the 12 months before and after, with laboratory findings determined at the baseline and at 12 months after dapagliflozin administration. In addition, the annual decrease in the eGFR (eGFR slope) was compared before and one year after the baseline readings, and the eGFR slope values before and after dapagliflozin administration in 34 rapid decliner cases with an eGFR slope >5 mL/min/1.73 m/year before dapagliflozin administration and 19 cases with an eGFR <25 mL/min/1.73 m at baseline were compared. Results The body mass index, blood pressure, uric acid, and urine protein-to-creatinine ratio significantly decreased, and hemoglobin levels significantly increased after dapagliflozin administration. There was a significant increase after administration in the mean eGFR slope of all cases, rapid decliners, and cases with an eGFR <25 mL/min/1.73 m at baseline (all p<0.001). Furthermore, there was a higher ratio of improvement in the eGFR slope in 39 patients who underwent multidisciplinary care within 1 year of dapagliflozin administration. Conclusion Dapagliflozin is effective in preventing renal function decline in patients with rapidly worsening or advanced CKD, with the effect further enhanced after combination with multidisciplinary care.