Quételet (body mass) index and effects of dapagliflozin in chronic kidney disease

Chertow, G. M. et al. (2022) Quételet (body mass) index and effects of dapagliflozin in chronic kidney disease. Diabetes, Obesity and Metabolism, 24(5), pp. 827-837. (doi: 10.1111/dom.14641) (PMID:34984791)

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Aim: To assess the effects of dapagliflozin in patients with chronic kidney disease (CKD) and albuminuria, with and without type 2 diabetes, stratified by the Quételet (body mass) index (BMI). Methods: We randomized 4304 adult patients with an estimated glomerular filtration rate (eGFR) of 25-75 ml/min/1.73m2 and urinary albumin-to-creatinine ratio of 200-5000 mg/g to dapagliflozin 10 mg/day or placebo. The primary outcome was a composite of sustained decline in eGFR of 50% or more, kidney failure, or death from kidney or cardiovascular causes. Secondary outcomes included kidney composite endpoint (primary composite endpoint without cardiovascular death), cardiovascular composite endpoint (hospitalized heart failure/ cardiovascular death), and all-cause mortality. We categorized participants according to World Health Organization BMI criteria: lean/ideal (<25 kg/m2), overweight (25-< 30 kg/m2), grade 1 obesity (30-<35 kg/m2), and grade 2/3 obesity (≥35 kg/m2). Results: Of 4296 (99.8%) randomized participants, 888 (20.7%), 1491 (34.7%), 1136 (26.4%), and 781 (18.2%) were categorized as lean/ideal, overweight, grade 1 obesity, and grade 2/3 obesity, respectively. Median follow-up was 2.4 years. Benefits of dapagliflozin were observed independent of baseline BMI for primary and secondary endpoints. Hazard ratios (95% CI) for dapagliflozin versus placebo for the primary composite endpoint were 0.60 (0.43, 0.85), 0.55 (0.40, 0.75), 0.71 (0.49, 1.04), and 0.57 (0.37, 0.87) among participants in the lean/ideal, overweight, grade 1 obesity, and grade 2/3 obesity groups (interaction P = .72). Conclusion: Among participants with CKD and albuminuria, with or without type 2 diabetes, kidney and cardiovascular benefits of dapagliflozin were evident and consistent across the BMI spectrum.

Item Type:Articles
Glasgow Author(s) Enlighten ID:McMurray, Professor John
Authors: Chertow, G. M., Vart, P., Jongs, N., Langkilde, A. M., McMurray, J. J.V., Correa‐Rotter, R., Rossing, P., Sjöström, C. D., Stefansson, B. V., Toto, R. D., Wheeler, D. C., and Heerspink, H. J. L.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Diabetes, Obesity and Metabolism
ISSN (Online):1463-1326
Published Online:04 January 2022

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