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DAPA-CKD randomized patients with chronic kidney disease and albuminuria to dapagliflozin or placebo, including many participants without diabetes. Dapagliflozin reduced the risk of sustained decline in kidney function, kidney failure or cardiovascular death and reduced the overall renal composite endpoint. The trial demonstrated that the kidney benefits of SGLT2 inhibition extend beyond glucose lowering. For internists, this is important because CKD may be present in patients who do not have diabetes yet remain at substantial renal and cardiovascular risk. Albuminuria should be measured routinely because it helps define both prognosis and eligibility for disease-modifying treatment. Dapagliflozin should be considered within an integrated CKD pathway alongside blood-pressure control, renin–angiotensin system blockade, sodium management and treatment of cardiovascular risk. The study also illustrates the value of enrolling patients according to kidney phenotype rather than a single underlying disease, a principle increasingly reflected in modern cardiorenal medicine.
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DAPA-CKD randomized patients with chronic kidney disease and albuminuria to dapagliflozin or placebo, including many participants without diabetes. Dapagliflozin reduced the risk of sustained decline in kidney function, kidney failure or cardiovascular death and reduced the overall renal composite endpoint. The trial demonstrated that the kidney benefits of SGLT2 inhibition extend beyond glucose lowering. For internists, this is important because CKD may be present in patients who do not have diabetes yet remain at substantial renal and cardiovascular risk. Albuminuria should be measured routinely because it helps define both prognosis and eligibility for disease-modifying treatment. Dapagliflozin should be considered within an integrated CKD pathway alongside blood-pressure control, renin–angiotensin system blockade, sodium management and treatment of cardiovascular risk. The study also illustrates the value of enrolling patients according to kidney phenotype rather than a single underlying disease, a principle increasingly reflected in modern cardiorenal medicine.
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