Does dapagliflozin protect kidney function in patients with diabetes?

This study looked at the effect of dapagliflozin (Farxiga) on kidney disease in patients with type 2 diabetes. It found patients treated with dapagliflozin were significantly less likely to have a decline in kidney function.

In type 2 diabetes (T2D), the body no longer regulates blood sugar well. If blood sugar is not well controlled, over the years high blood sugar can damage tissues including the kidneys. The kidneys contain nephrons, tiny filters that remove waste from the blood. The waste is passed out of the body in urine.

Glucose passes through a type of small channel within the nephron, sodium-glucose transport protein 2 (SGLT2). The medication dapagliflozin blocks SGLT2. By preventing glucose from passing back into the blood, dapagliflozin lowers blood sugar levels. SGLT2-blockers may also prevent rapid filtering (glomerular hyperfiltration), which is a risk for kidney disease. Other SGLT2-blockers lower the risk of kidney disease. How dapagliflozin affects kidney disease in patients with diabetes is still under investigation.

This study looked at 17,160 patients with T2D who had or were at risk for heart disease. At the start of the study, most patients had normally functioning kidneys (average estimated glomerular filtration rate (eGFR) = 85.2 mL/min per 1.73 m²). 7.4% of patients had a moderately impaired kidney function (eGFR less than 60 mL/ min per 1.73 m^2). Half the patients received dapagliflozin, and half received a placebo. The patients were followed for an average of 4.2 years.

Patients treated with dapagliflozin were 46% less likely to have a decline in kidney function. Patients treated with dapagliflozin were also 59% less likely to develop kidney failure or death due to kidney disease. 

This study found dapagliflozin significantly decreased the likelihood of a decline in kidney function in patients with diabetes.

This study was funded by AstraZeneca, the manufacturer of Farxiga.