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Quételet (Body Mass) Index and Effects of Dapagliflozin in CKD

Chertow, GM; Vart, P; Jongs, N; Langkilde, AM; McMurray, JJV; Correa-Rotter, R; Rossing, P; ... Heerspink, HJL; + view all (2022) Quételet (Body Mass) Index and Effects of Dapagliflozin in CKD. Diabetes, Obesity and Metabolism 10.1111/dom.14641. (In press).

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Diabetes Obesity Metabolism - 2022 - Chertow - Qu telet Body Mass Index and Effects of Dapagliflozin in CKD.pdf - Accepted Version
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Abstract

AIMS: This post-hoc analysis of DAPA-CKD (NCT03036150) assessed the effects of dapagliflozin in patients with chronic kidney disease (CKD) and albuminuria, with and without type 2 diabetes, stratified by the Quételet (body mass) index (BMI). METHODS: We randomized 4304 adult patients with estimated glomerular filtration rate (eGFR) of 25-75 mL/min/1.73m2 and urinary albumin-to-creatinine ratio of 200-5000 mg/g to dapagliflozin 10 mg/day or placebo. The primary outcome was a composite of sustained decline in eGFR of ≥50%, kidney failure, or death from kidney or cardiovascular causes. Secondary outcomes included kidney composite endpoint (primary composite endpoint without cardiovascular death), cardiovascular composite endpoint (hospitalized heart failure/ cardiovascular death), and all-cause mortality. We categorized participants according to World Health Organization BMI criteria: lean/ideal (<25 kg/m2 ), overweight (25- < 30 kg/m2 ), grade 1 obesity (30- < 35 kg/m2 ) and grade 2/3 obesity (≥35 kg/m2 ). RESULTS: Of 4296 (99.8%) randomized participants, 888 (20.7%), 1491 (34.7%), 1136 (26.4%), and 781 (18.2%) were categorized as lean/ideal, overweight, grade 1 obesity, and grade 2/3 obesity, respectively. Median follow-up was 2.4 years. Benefits of dapagliflozin were observed independent of baseline BMI for primary and secondary endpoints. Hazard ratios (95% CI) for dapagliflozin versus placebo for the primary composite endpoint were 0.60 (0.43, 0.85), 0.55 (0.40, 0.75), 0.71 (0.49, 1.04), and 0.57 (0.37, 0.87), among participants in the lean/ideal, overweight, grade 1 obesity, and grade 2/3 obesity groups (interaction p = 0.72). CONCLUSION: Among participants with CKD and albuminuria, with or without type 2 diabetes, kidney and cardiovascular benefits of dapagliflozin were evident and consistent across the BMI spectrum. This article is protected by copyright. All rights reserved.

Type: Article
Title: Quételet (Body Mass) Index and Effects of Dapagliflozin in CKD
Location: England
DOI: 10.1111/dom.14641
Publisher version: https://doi.org/10.1111/dom.14641
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Quételet index, body mass index, chronic kidney disease, clinical trial, dapagliflozin, obesity
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10141830
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