Dapagliflozin therapy not linked to renal damage in heart failure patients

A new study by Nakase and team showed that patients with heart failure with a reduced ejection fraction (HFrEF) who saw a brief drop in estimated glomerular filtration rate (eGFR) after starting dapagliflozin did not often have renal tubular damage, and the drop might have been caused by a hemodynamic change instead. The findings of this study were published in Internal Medicine.

Uncertainty exists regarding the connection between the early decline in glomerular filtration rate (GFR) following the start of sodium-glucose co-transporter 2 inhibitors (SGLT2) and renal tubular damage in patients with heart failure and a low ejection fraction. Therefore, this study looked at how dapagliflozin treatment in individuals with HFrEF affected changes in estimated GFR and urine N-acetyl-D-glucosaminidase (uNAG).

Researchers looked at 89 individuals with HFrEF who had recently begun using dapagliflozin 10 mg/day for this trial. After starting dapagliflozin, changes in the eGFR and uNAG-to-creatinine ratio (uNAG/Cre) were assessed after 2 weeks and 2 months.

The key findings of this study were:

1. At two weeks, the eGFR started to fall, but by two months, it hadn't dropped any lower.

2. The uNAG/Cre was raised at two weeks, but by two months, it had not gone up any more.