“Evaluation of Cardiovascular and Renal Outcomes of Dapagliflozin in Patients of Type2 Diabetes Mellitus with Chronic Kidney Disease

Abstract

Background and objective: Diabetic nephropathy, often known as DN, is the condition that is responsible for the majority of diabetes-related cases of chronic kidney disease. Since the 1990s, we have been employing RAAS blocking, which encompasses aldosterone antagonists such as spironolactone and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, in order to delay the progression of diabetic nephropathy. After the advent of novel anti-hyperglycemic drugs, such as SGLT2 (sodium-glucose-linked transporter type 2) inhibitors, the focus of therapy has switched from controlling difficulties to avoiding micro- and macrovascular
consequences. This shift in focus has occurred because of the introduction of these therapies. It has been since the introduction of these medications that this shift in strategy has taken place. This modification came about as a consequence of the introduction of these innovative drugs. When it comes to the treatment of type 2 diabetes mellitus (T2DM), chronic kidney disease (as proved by the DAPA-CKD study), and heart failure (as revealed by the DAPA-HF research), dapagliflozin, which is an SGLT2 inhibitor, has been shown to be successful. Due to the fact that, in the context of our setup, no previous study of a comparable kind had been conducted to determine the impact of dapagliflozin on diabetic patients who had been diagnosed with chronic kidney disease (CKD), this investigation was carried out.
Material and methods: This clinical inquiry lasted for a period of one and a half years, beginning in June 2021 and ending in November 2022. It was a prospective observational study from a clinical perspective. The research was carried out with the participation of sixty individuals who had a history of both type 2 diabetes and chronic kidney disease (CKD). Dapagliflozin, 10 milligrams once day, was administered to thirty individuals as part of their routine therapy for type 2 diabetes with chronic kidney disease (CKD). The standard treatment approach was utilized for the remaining thirty individuals who were diagnosed with type 2 diabetes. Within the scope of this analysis, the effects of dapagliflozin on modifiable variables were the primary consideration. A complete set of measurements was obtained, including those pertaining to safety, weight, estimated glomerular filtration rate, albumin-creatinine ratio in urine, systolic and diastolic blood pressure, and both. The first recording of the parameters was place at the beginning of the study, and further evaluations took place three, six, and twelve months after the initial recording session.
Results: At the end of the year, the research discovered that a number of factors, including blood pressure, urine albumin-creatinine ratio, body weight, glycated hemoglobin, fasting blood sugar, and mean estimated glomerular filtration rate, all experienced a significant decline (p=0.0001, p=0.0001, p=0.0001, p=0.0001, p=0.0001, p=0.0001, p=0.0001, p=0.0001, p=0.0001, p=0.0004. When it comes to adverse drug reactions (ADRs), the most common ones were infections of the urinary system or vaginal tract, nausea, vomiting, and
gastrointestinal discomfort. There was a statistically significant increase in the frequency of adverse drug reactions (ADRs) in the group that was given dapagliflozin (67.6% vs to 32.4% in the control arm; p=0.0006). However, the vast majority of the occurrences were found to be on the less serious side.
Conclusion: Dapagliflozin was well accepted by individuals with type 2 diabetes and chronic renal illness, and it was able to considerably enhance the parameters of glucose management, kidney function, and heart function when it was added to the usual treatment. In addition to this, there was a significant improvement in the management of blood sugar. According to the findings of this study, those who have type 2 diabetes mellitus are at a greater risk of developing genitourinary infections.”