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

Abstract

This meta-analysis was conducted by searching PubMed, Scopus, Cochrane, Ovid till November 2022 for randomized controlled trials (RCTs) that utilized dapagliflozin 10 mg as adjunctive therapy in patients with T2DM and CKD stage 2-5 and reported its renal efficacy in terms of mean change in estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (UACR) from baseline. From 1682 identified records, nine studies representing 13,057 patients were selected for this study. Pooled estimate of five studies showed that dapagliflozin did not affect eGFR but caused significantly less chronic eGFR decline than placebo in two studies [Mean difference (MD) +2.74 (95% CI: 1.55, 3.92; p < 0.00001)]. Pooled estimate of four studies showed that dapagliflozin significantly reduced UACR[-23.99 % MD (95% CI - 34.82, -13.15, p-value < 0.0001; = 0%)]. This confirms that long-term dapagliflozin use significantly attenuates eGFR decline and reduces albuminuria in T2DM and CKD stages 2-5 patients.

Keywords: Chronic kidney disease, Dapagliflozin, Estimated GFR, eGFR, SGLT2 inhibitors, Type 2 diabetes mellitus, Urine albumin to creatinine ratio, UACR.