Impact of Dapagliflozin Adjunctive Therapy on the Progression of Chronic Kidney Disease in Patients with Type 2 Diabetes and Chronic Kidney Disease Stages 2-5: A systematic review and meta-analysis

Sultan Qaboos Univ Med J. 2024 Aug;24(3):317-326. doi: 10.18295/squmj.12.2023.093. Epub 2024 Aug 29.

Abstract

This meta-analysis investigated efficacy of dapagliflozin as adjunctive therapy for patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) stages 2-5. A systematic search was conducted of selected databases for randomised controlled trials that reported the mean change in estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) from baseline. Out of 1,682 identified studies, 9 trials comprising 13,057 patients were included. A pooled estimate of 5 studies indicated that dapagliflozin did not affect eGFR; however, in 2 studies, it significantly reduced chronic eGFR decline compared to placebo (mean difference [MD] ± 2.74; 95% confidence interval [CI]: 1.55, 3.92; P <0.00001). Additionally, a pooled estimate of 4 studies showed that dapagliflozin significantly reduced UACR (MD -23.99%; 95% CI: -34.82--13.15; P <0.0001; I2 = 0%). Therefore, long-term use of dapagliflozin significantly attenuates eGFR decline and reduces albuminuria in patients with T2DM and CKD.

Keywords: Albuminuria; Chronic Kidney Disease; Dapagliflozin; Glomerular Filtration Rate; SGLT2 Inhibitors; Type 2 Diabetes Mellitus.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Benzhydryl Compounds* / pharmacology
  • Benzhydryl Compounds* / therapeutic use
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Disease Progression
  • Female
  • Glomerular Filtration Rate / drug effects
  • Glucosides* / pharmacology
  • Glucosides* / therapeutic use
  • Humans
  • Male
  • Renal Insufficiency, Chronic* / drug therapy
  • Renal Insufficiency, Chronic* / physiopathology
  • Sodium-Glucose Transporter 2 Inhibitors / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use

Substances

  • dapagliflozin
  • Glucosides
  • Benzhydryl Compounds
  • Sodium-Glucose Transporter 2 Inhibitors