Kidney Week

Abstract: SA-PO351

Effects of Dapagliflozin on Sodium Excretion and Blood Pressure in Patients with Type 2 Diabetes and CKD during Standardized Sodium Intake

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Research
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Beernink, Jelle, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Jelle Beernink, MD

• Jongs, Niels, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Niels Jongs, PhD

• Sridhar, Vikas, University Health Network, Toronto, Ontario, Canada

Vikas Sridhar, MD

• Mosterd, Charlotte, Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, Netherlands

Charlotte Mosterd, MD

• Scholtes, Rosalie, Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, Netherlands

Rosalie Scholtes, MD, PhD

• Caldwell, Alyssa, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Alyssa Caldwell, MS

• Casillas, Daniel Isaiah, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Daniel Isaiah Casillas

• Driscoll, Lynette M., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Lynette M. Driscoll, MA, PA

• Greasley, Peter J., AstraZeneca, Mölndal, Sweden

Peter J. Greasley, PhD

• van Raalte, Daniël H., Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, Netherlands

Daniël H. van Raalte, MD, PhD

• Bjornstad, Petter, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Petter Bjornstad, MD

• Cherney, David, University Health Network, Toronto, Ontario, Canada

David Cherney, MD, PhD

• Heerspink, Hiddo Jan L., Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Hiddo Jan L. Heerspink, PhD

Group or Team Name

• DAPASALT Investigators.

Background

We previously demonstrated that dapagliflozin reduced blood pressure (BP) without altering natriuresis in patients with type 2 diabetes (T2D) and preserved kidney function. Chronic kidney disease (CKD) is often associated with salt-sensitive hypertension, which is resistant to many anti-hypertensive drugs. In this prospective study, we assessed the effects of dapagliflozin on sodium excretion and BP in patients with T2D and CKD during standardized sodium intake.

Methods

We conducted a prospective open-label study to evaluate the effects of dapagliflozin on 24-hour sodium excretion, 24-hour BP, and extracellular volume (EV) in patients with T2D with CKD (estimated glomerular filtration rate [eGFR] of ≥25 and ≤50 mL/min per 1.73m²) at the start of treatment (ST) (days 2-4), end of treatment (ET) (days 12-14), and washout (days 15-18) during controlled sodium intake (150 mmol/day).

Results

Thirteen patients (mean age 70 ± 9.6 years, eGFR 41 ± 12.6 mL/min per 1.73m², 24-hour systolic BP 130 ± 23.1 mmHg) were included. Mean 24-hour sodium excretion did not change during the study (Table 1). Nominal decreases in 24-hour systolic and diastolic BP were observed, without changes in EV. Mean 24-hour urinary glucose excretion increased at ST and ET and reversed during wash-out.

Conclusion

In patients with T2D and CKD, dapagliflozin reduced BP during standardized sodium intake, without increasing natriuresis. These findings are consistent with those in patients with T2D and preserved kidney function, and suggest that BP lowering with dapagliflozin may be attributed to different mechanisms than natriuresis in patients with and without CKD.

Table 1: Change from baseline (95% CI)

Funding

• Commercial Support – AstraZeneca