Heerspink HJL, Jongs N, Chertow GM, et al. - Long-term estimated glomerular filtration rate (eGFR) decline in chronic kidney disease is significantly slowed by dapagliflozin vs placebo. Between patients who received dapagliflozin vs placebo, the mean difference in eGFR slope was found to be greater in patients with type 2 diabetes, higher HbA _1c , and higher urinary albumin-to-creatinine ratio.

• In the DAPA-CKD trial, dapagliflozin decreased the risk of renal failure in patients with chronic kidney disease with and without type 2 diabetes.

• This pre-specified analysis was conducted to examine dapagliflozin’s impact on the rate of change in eGFR—ie, the eGFR slope.

• A total of 2,152 (50%) patients received dapagliflozin and 2,152 (50%) received placebo.

• In the whole cohort, dapagliflozin vs placebo slowed eGFR reduction by 0·95 mL/min per 1·73 m ² per year, from baseline to the end of treatment.

• An acute eGFR decline of 2·61 mL/min per 1·73 m ² (2·16 to 3·06) and 2·01 mL/min per 1·73 m ² (1·36 to 2·66) in patients with and without type 2 diabetes, respectively, was seen with dapagliflozin vs placebo, between baseline and week 2.

• Dapagliflozin vs placebo decreased the mean rate of eGFR decline by a greater amount in those with type 2 diabetes than patients without type 2 diabetes, between week 2 and end of treatment.