# Impact of Dapagliflozin Adjunctive Therapy on the Progression of Chronic Kidney Disease in Patients with Type 2 Diabetes and Chronic Kidney Disease Stages 2–5: A systematic review and meta-analysis

## TL;DR

This study finds that dapagliflozin helps slow kidney function decline and reduce albuminuria in type 2 diabetes patients with chronic kidney disease.

## Contribution

The study provides new evidence that dapagliflozin significantly reduces eGFR decline and albuminuria in T2DM patients with CKD stages 2–5.

## Key findings

- Dapagliflozin significantly reduced chronic eGFR decline compared to placebo.
- Dapagliflozin significantly reduced urine albumin-creatinine ratio (UACR).
- The effect on eGFR was not observed in all studies but was significant in two.

## Abstract

This meta-analysis investigated efficacy of dapagliflozin as adjunctive therapy for patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) stages 2–5. A systematic search was conducted of selected databases for randomised controlled trials that reported the mean change in estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) from baseline. Out of 1,682 identified studies, 9 trials comprising 13,057 patients were included. A pooled estimate of 5 studies indicated that dapagliflozin did not affect eGFR; however, in 2 studies, it significantly reduced chronic eGFR decline compared to placebo (mean difference [MD] ± 2.74; 95% confidence interval [CI]: 1.55, 3.92; P <0.00001). Additionally, a pooled estimate of 4 studies showed that dapagliflozin significantly reduced UACR (MD −23.99%; 95% CI: −34.82–−13.15; P <0.0001; I2 = 0%). Therefore, long-term use of dapagliflozin significantly attenuates eGFR decline and reduces albuminuria in patients with T2DM and CKD.