Effects of dapagliflozin on sodium excretion, blood pressure and volume status in patients with type 2 diabetes and/or chronic kidney disease: The DAPASALT trial
Authors' conclusion
Dapagliflozin reduced blood pressure during standardised sodium intake in patients with type 2 diabetes and/or CKD without increasing sodium excretion, suggesting that the blood pressure-lowering effects occur through mechanisms beyond natriuresis.
Study context
- Population
- Patients with T2D and/or chronic kidney disease (CKD) under standardised sodium intake (150 mmol/day)33 pooled across strata
- Participants
- 13 vs 33
- Comparison
- Dapagliflozin treatment vs baseline
- T2D and CKDn = 13
- Pooledn = 33
- Outcome
- 24-h sodium excretion and blood pressure, change from baseline
- Follow-up
- Day 4 and Day 14
Methodological detailsnonrandomised, open-label, standardised sodium intake (150 mmol/day)
- Nonrandomised
- Open-label
- Standardised sodium intake (150 mmol/day)
Main finding
As reported in the abstract
24-h sodium excretion did not increase; Day 4 change (95% CI −15.4, 14.5), p = 0.95
−0.5 mmol/24-h
24-h sodium excretion Day 14 change
−11.7 mmol/24-h
95% CI −30.4, 7.1
24-h systolic BP decrease vs baseline at Day 4
6.0 mmHg
95% CI −19.8, 7.7
24-h systolic BP decrease vs baseline at Day 14
3.7 mmHg
95% CI −13.7, 6.2
Further findings
Change from baseline in 24-h sodium excretion and 24-h systolic BP, pooled stratum · Day 4 and Day 14
- 24-h sodium excretion unchanged; Day 4 change (95% CI −16.2, 1.5), p = 0.10
- −7.4 mmol/24-h
- 24-h sodium excretion Day 14 change (95% CI −25.1, 5.0), p = 0.18
- −10.1 mmol/24-h
- 24-h systolic BP reduction at Day 4 (95% CI −10.4, −3.3), p < 0.001
- 6.8 mmHg
- 24-h systolic BP reduction at Day 14 (95% CI −10.1, −3.0), p < 0.001
- 6.5 mmHg
- No evidence of heterogeneity across strata
Original publication
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