- In patients with type 2 diabetes (T2D) and kidney disease, canagliflozin reduced the risk of renal failure and cardiovascular events compared with placebo.
Why this matters
- Type 2 diabetes increases the risk of kidney failure.
- Studies of sodium-glucose transporters in cardiovascular disease showed an improvement in renal outcomes in patients with T2D.
- Randomized, double-blind trial of 4401 patients with T2D and albuminuric chronic kidney disease to receive canagliflozin 100 mg daily or placebo.
- Patients had an estimated glomerular filtration rate (eGFR) of 30 to 2 and albuminuria (albumin to creatinine ratio >300-5000 mg/g) and were treated with renin-angiotensin system blockade.
- Primary endpoint was a composite of end-stage kidney disease (dialysis, transplantation, or sustained eGFR of 15 mL/minute/1.73 m2), doubling of serum creatinine, or death from renal or cardiovascular causes.
- At the follow-up of 2.62 years, there was a decrease in the relative risk of the composite of end-stage kidney disease, doubling of the creatinine level, death from renal causes in the canagliflozin group by 34% (HR 0.66; 95% CI, 0.53-0.81; P<.001 and in the relative risk of end-stage kidney disease group by ci p=".002).</li">
- There was a lower risk of cardiovascular death, myocardial infarction, or stroke, and hospitalization for heart failure (HR 0.61, 95% CI, 0.47-0.80, P<.001>