Effect of dapagliflozin on renal haemodynamics in hyperfiltering T2D patients
Authors' conclusion
Despite comparable glycaemic control, dapagliflozin treatment, but not metformin and /or glipizide, reduced glomerular hyperfiltration in T2D patients and decreased both filtration fraction and renal vascular resistance. These findings suggest that a post-glomerular vasodilatory action of SGLT2 inhibitors contributes to their renal protective effect in T2D.
Study context
- Population
- T2D patients with elevated (hyperfiltration >125 mL/min/1.73 m², iohexol GFR) or normal GFR
- Participants
- 60 patients
- Comparison
- Dapagliflozin 10 mg/day vs metformin/glipizide in hyperfiltering and normofiltering T2D
- DAPA/HYPERn = 15
- DAPA/NORMOn = 15
- CONTROL/HYPERn = 15reference
- CONTROL/NORMOn = 15reference
- Primary endpoint
- Renal haemodynamics: GFR, RPF, MAP, filtration fraction and renal vascular resistance
- Follow-up
- 4 months
Primary result
As reported in the abstract
Change in GFR, RPF, FF, MAP and RVR
- GFR decline in DAPA/HYPER
- ≈18%
- GFR decline in DAPA/NORMO
- ≈7%
- FF (%) in DAPA/HYPER, before to after
- 0.23 ± 0.01 to 0.18 ± 0.01
- FF (%) in DAPA/NORMO, before to after
- 0.17 ± 0.01 to 0.15 ± 0.01
- MAP (mmHg) in DAPA/HYPER, before to after
- 95.4 ± 1.4 to 88.1 ± 1.3
- MAP (mmHg) in DAPA/NORMO, before to after
- 95.6 ± 1.3 to 91.8 ± 0.8
- RVR (mmHg/L/min) in DAPA/HYPER, before to after
- 92.7 ± 7.8 to 80.4 ± 6.1
- RVR (mmHg/L/min) in DAPA/NORMO, before to after
- 90.1 ± 3.0 to 81.4 ± 2.1
Further findings
- HbA1c decreased similarly in all 4 groups
Original publication
Effect of dapagliflozin on renal haemodynamics in hyperfiltering T2D patients. Diabetes Obes Metab. Published 27 November 2024. doi:10.
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