With chronic kidney disease (CKD) on the rise in the United States, scientists are developing new medications to help reduce the risk of developing and worsening CKD. Learn more about the new FDA-approved medication, dapagliflozin (Farxiga®, AstraZeneca), which may reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in CKD patients.* 

What Did the Research Find? 

Data from the Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial showed significant prevention in the decline of kidney function, also known as estimated glomerular filtration rate (eGFR). 

CKD participants receiving dapagliflozin, a sodium-glucose co-transporter 2 inhibitor, kept kidney function longer and would not require dialysis for 19.8 years, compared to 9.6 years in the placebo group. The slowing down in the decline of eGFR could mean that patients never require dialysis or need it for a lot less time. 

Another significant benefit of the medication was an average risk reduction in cardiovascular death or heart failure hospitalization after about four to six weeks. Since CKD patients are more likely to die before requiring dialysis, this is an incredibly significant finding. 

Who Should Not Take Dapagliflozin?

During the study, researchers had many participants with CKD caused by different conditions. However, certain patients were excluded from the study and should not take the medication until more research is done. This would include patients with:

• Autosomal dominant or recessive polycystic kidney disease
• Those who require or have recently used immunosuppressive therapy to treat kidney disease
• Those with type 1 diabetes mellitus (DM)

What Are the Concerns?

Thus far, there are few concerns regarding adverse reactions. Overall, dapagliflozin was well-tolerated among the study’s participants, and there was no significant difference in adverse reactions compared to the placebo group. 

Like many new drugs, the main concern is regarding cost and insurance coverage. Hopefully, the compelling data will encourage the government, insurance companies and drug manufacturers to come together to make dapagliflozin available to those who need it.

*Sloan, L. (2021, July 19). New drug therapy will change the CKD landscape. Healio. https://www.healio.com/news/nephrology/20210707/new-drug-therapy-will-change-the-ckd-landscape