Efficacy of dapagliflozin on uric acid in patients with moderate-to-severe chronic kidney disease.

AIMS: We investigated the efficacy of dapagliflozin, which is a sodium-glucose cotransporter 2 inhibitor, on uric acid (UA) in individuals with moderate-to-severe chronic kidney disease (CKD) (stage G3-4).

METHODS

We retrospectively studied 46 patients (mean age: 66.6 ± 14.1 years; 32 men and 14 women) after 12 months of dapagliflozin treatment. We recorded the change in UA and urine protein. All of the patients had moderate-to-severe CKD (mean estimated glomerular filtration rate: 35.9 ± 10.9 mL/min/1.73 m2; stage G3, n = 32; G4, n = 14). The data of 46 matched patients with similar propensity scores (who did not take dapagliflozin) were analyzed as a control group.

RESULTS

UA concentrations significantly decreased from baseline to 12 months in the dapagliflozin group (6.4 ± 1.2 mg/dL to 5.6 ± 1.4 mg/dL, probability (p) < 0.05) but UA concentrations did not change in the control group. In addition, UA concentrations were significantly lower in the dapagliflozin group than in the control group at 12 months (5.6 ± 1.4 mg/dL vs. 6.4 ± 1.4 mg/dL, p < 0.05). UA concentrations significantly decreased from baseline to 12 months in patients with CKD stage G3 in the dapagliflozin group at 12 months (6.4 ± 0.9 mg/dL to 5.4 ± 1.0 mg/dL, p < 0.05) but UA concentrations did not change in patients with CKD stage G4.

CONCLUSIONS

Dapagliflozin can decrease UA concentrations in patients with moderate CKD. This finding suggests that dapagliflozin has a beneficial effect on UA metabolism in patients with moderate CKD.