Pharmacological Research (Sep 2022)
Dapagliflozin acutely improves kidney function in type 2 diabetes mellitus. The PRECARE study
- Elisa Lazzaroni,
- Maria Elena Lunati,
- Laura Montefusco,
- Ida Pastore,
- Enrica Chebat,
- Vincenzo Cimino,
- Paola Silvia Morpurgo,
- Milena Muratori,
- Laura Plebani,
- Andrea Bolla,
- Antonio Rossi,
- Luciana Vallone,
- Alessandra Gandolfi,
- Camilla Tinari,
- Francesca D’Addio,
- Moufida Ben Nasr,
- Cristian Loretelli,
- Cristiana Scaranna,
- Rosalia Bellante,
- Roberto Manfrini,
- Fabrizio Muratori,
- Ivano Franzetti,
- Emanuela Orsi,
- Carmine Gazzaruso,
- Renata Ghelardi,
- Paolo Desenzani,
- Stefano Genovese,
- Angela Girelli,
- Franco Folli,
- Cesare Berra,
- Paolo Fiorina
Affiliations
- Elisa Lazzaroni
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy; Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy
- Maria Elena Lunati
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Laura Montefusco
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Ida Pastore
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Enrica Chebat
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Vincenzo Cimino
- Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy; Endocrinology and Diabetology, Pio Albergo Trivulzio, Milan, Italy
- Paola Silvia Morpurgo
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Milena Muratori
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Laura Plebani
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Andrea Bolla
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Antonio Rossi
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Luciana Vallone
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Alessandra Gandolfi
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Camilla Tinari
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Francesca D’Addio
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy; Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy
- Moufida Ben Nasr
- Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy
- Cristian Loretelli
- Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy
- Cristiana Scaranna
- Division of Endocrinology and Diabetology, ASST Papa Giovanni XXIII, Bergamo, Italy
- Rosalia Bellante
- Division of Endocrinology and Diabetology, ASST Papa Giovanni XXIII, Bergamo, Italy
- Roberto Manfrini
- Endocrinology and Metabolism, Department of Health Science, Università degli Studi di Milano, Milan, Italy; Departmental Unit of Diabetes and Metabolism, San Paolo Hospital, ASST Santi Paolo e Carlo, Italy
- Fabrizio Muratori
- Division of Endocrinology and Diabetology, Sant'Anna Hospital - ASST Lariana, Como, Italy
- Ivano Franzetti
- Division of Endocrinology and Diabetology, S. Antonio Abate Hospital, Gallarate, Italy
- Emanuela Orsi
- Diabetes Service, Endocrinology and Metabolic Diseases Unit, IRCCS ''Cà Granda - Ospedale Maggiore Policlinico'' Foundation, Italy
- Carmine Gazzaruso
- Diabetes and Endocrine, Metabolic and Vascular Diseases Unit and the Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute ''Beato Matteo'' (Hospital Group San Donato), Vigevano, Italy
- Renata Ghelardi
- Unit of Diabetology, ASST Melegnano-Martesana, San Giuliano Milanese, Italy
- Paolo Desenzani
- Unit of Diabetology, ASST Spedali Civili, Montichiari, Brescia, Italy
- Stefano Genovese
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Angela Girelli
- Unit of Diabetology, Spedali Civili, Brescia, Italy
- Franco Folli
- Endocrinology and Metabolism, Department of Health Science, Università degli Studi di Milano, Milan, Italy; Departmental Unit of Diabetes and Metabolism, San Paolo Hospital, ASST Santi Paolo e Carlo, Italy
- Cesare Berra
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS Multimedica, Milan, Italy
- Paolo Fiorina
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy; Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy; Nephrology Division, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA; Correspondence to: Nephrology Division, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
- Journal volume & issue
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Vol. 183
p. 106374
Abstract
Dapagliflozin has been demonstrated to improve glycemic control, blood pressure, and body weight in type 2 diabetes mellitus (T2D); indeed, it can also reduce the risk of progression to renal failure, of hospitalization for heart failure and of cardiovascular death. We aim to investigate the acute effect of Dapagliflozin on kidney function in the common clinical practice in T2D. This is a study including 1402 patients with T2D recruited from 11 centers in Lombardia, Italy, who were evaluated at baseline and after 6 months of treatment with Dapagliflozin 10 mg per day. The primary outcome of the study was the change in HbA1c, while the secondary outcomes were modification of weight, BMI, systolic and diastolic pressure, creatinine, eGFR and albuminuria status. After 24 weeks of treatment with Dapagliflozin, a reduction in Hb1Ac was observed (−0.6 ± 1.8%) as well as in BMI (−1.5 ± 5.2 kg/m2). Statistically significant changes were also found for systolic and diastolic blood pressure, cholesterol and triglycerides. Interestingly, a statistically significant acute improvement of kidney function was evident. Our analyses confirm the beneficial effects of dapagliflozin after 6 months of therapy, with improvements of glycemic and lipid profiles, blood pressure, BMI. Finally, an acute positive effect on albuminuria and KIDGO classes was observed during a 6 months treatment with dapagliflozin in patients with T2D.