Rationale and protocol of the Dapagliflozin And Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) randomized controlled trial

Research output: Contribution to journalJournal articleResearchpeer-review

  • H. J.L. Heerspink
  • B. Stefansson
  • G. Chertow
  • R. Correa-Rotter
  • Tom Greene
  • Fan Fan Hou
  • Magnus Lindberg
  • John McMurray
  • Rossing, Peter
  • Roberto Toto
  • Anna Maria Langkilde
  • David C. Wheeler
  • H. J.L. Heerspink
  • D. C. Wheeler
  • G. Chertow
  • R. Correa-Rotter
  • T. Greene
  • F. F. Hou
  • J. McMurray
  • Rossing, Peter
  • R. Toto
  • B. Stefansson
  • A. M. Langkilde
  • Marc A. Pfeffer
  • Stuart Pocock
  • Karl Swedberg
  • Jean L. Rouleau
  • Nishi Chaturvedi
  • Peter Ivanovich
  • Andrew S. Levey
  • Heidi Christ-Schmidt
  • Johannes Mann
  • Claes Held
  • Christoph Varenhorst
  • Pernilla Holmgren
  • Theresa Hallberg
  • Walter Douthat
  • Roberto Pecoits Filho
  • David Cherney
  • Fan Fan Hou
  • Frederik Persson
  • Hermann Haller
  • István Wittmann
  • Dinesh Khullar
  • Kashihara Naoki
  • Richardo Correa-Rotter
  • Elizabeth Escudero
  • Rey Isidto
  • Michal Nowicki
  • Mikhail Batiushin
  • DAPA-CKD Investigators

Background. Recent cardiovascular outcome trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors slow the progression of chronic kidney disease (CKD) in patients with type 2 diabetes at high cardiovascular risk. Whether these benefits extend to CKD patients without type 2 diabetes or cardiovascular disease is unknown. The Dapagliflozin and Prevention of Adverse Outcomes in CKD (DAPA-CKD) trial (NCT03036150) will assess the effect of the SGLT2 inhibitor dapagliflozin on renal and cardiovascular events in a broad range of patients with CKD with and without diabetes. Methods. DAPA-CKD is a randomized, double-blind, placebo-controlled, trial in which -4300 patients with CKD Stages 2-4 and elevated urinary albumin excretion will be enrolled. The vast majority will be receiving a maximum tolerated dose of a renin-angiotensin system inhibitor at enrolment. Results. After a screening assessment, eligible patients with a urinary albumin:creatinine ratio =200 mg/g and estimated glomerular filtration rate (eGFR) between 25 and 75 mL/min/ 1.73 m2 are randomly assigned to placebo or dapagliflozin 10 mg/day. Enrolment is monitored to ensure that at least 30% of patients do not have diabetes and that no more than 10% have an eGFR >60 mL/min/1.73 m2. The primary endpoint is a composite of a sustained decline in eGFR of =50%, end-stage renal disease, renal death or cardiovascular death. The trial will conclude when 681 primary renal events have occurred, providing 90% power to detect a 22% relative risk reduction (a level of 0.05). Conclusion. DAPA-CKD will determine whether the SGLT2 inhibitor dapagliflozin, added to guideline-recommended therapies, safely reduces the rate of renal and cardiovascular events in patients across multiple CKD stages with and without diabetes.

Original languageEnglish
JournalNephrology Dialysis Transplantation
Volume35
Issue number2
Pages (from-to)274-282
ISSN0931-0509
DOIs
Publication statusPublished - Feb 2020

    Research areas

  • Chronic kidney disease, Dapagliflozin, Randomized controlled clinical trial, Sodiumglucose co-transporter inhibitor

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