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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Abstract
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 |
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Status: | Published |
Refereed: | Yes |
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 |
Publisher: | Wiley |
ISSN: | 1462-8902 |
ISSN (Online): | 1463-1326 |
Published Online: | 04 January 2022 |
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