TY - JOUR
T1 - Cardiac impact of dapagliflozin in advanced chronic kidney disease
T2 - rationale and design of the Renal Lifecycle Trial cardiac imaging sub-studies
AU - Karsten, Micky
AU - Badve, Sunil V
AU - Gansevoort, Ron T
AU - Berger, Stefan P
AU - Heerspink, Hiddo J L
AU - Abrahams, Alferso C
AU - Billot, Laurent
AU - Bon, Rianne H A C M
AU - Gelens, Mariëlle A C J
AU - Guinness, Dean
AU - Hamilton-Craig, Christian
AU - van Heerebeek, Loek
AU - Hemmelder, Marc H
AU - Houston, Lauren
AU - Kozor, Rebecca
AU - Kuypers, Dirk R J
AU - Monaghan, Helen
AU - Neal, Bruce
AU - Neuen, Brendon L
AU - Otton, James
AU - Perkovic, Vlado
AU - Rajwani, Adil
AU - Wang, Angela Y
AU - Vervloet, Marc G
AU - Arnott, Clare
AU - Jakulj, Lily
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2026/1
Y1 - 2026/1
N2 - Background. Patients with chronic kidney disease (CKD) are frequently hospitalized for heart failure. Sodium-glucose co-transporter 2 (SGLT2)-inhibitors improve cardiorenal outcomes in CKD and heart failure, at least in estimated glomerular filtration rate (eGFR) ranges 20-60 ml/min/1.73 m2, possibly through direct cardiac effects. In the cardiac imaging sub-studies of the Renal Lifecycle Trial, we aim to establish the effects of SGLT2-inhibition on cardiac structure and function in patients with advanced CKD, kidney failure and in kidney transplant recipients. Methods. In the Renal Lifecycle Trial, patients with advanced CKD (eGFR ≤25 ml/min/1.73 m2), those treated with hemodialysis or peritoneal dialysis (PD) or kidney transplant recipients (eGFR ≤45 ml/min/1.73 m2), are randomized to receive either dapagliflozin or placebo. The echocardiography sub-study (acronym: STOP-HF-in-PD) will enroll 100 PD-treated patients, who undergo echocardiography at baseline, and at 6 and 12 months post-randomization. In the cardiac magnetic resonance imaging (MRI) sub-study, 250 Renal Lifecycle Trial participants across all three groups (i.e. advanced CKD, dialysis, kidney transplant recipients), including a subset of STOP-HF-in-PD participants, will undergo cardiac MRI at baseline, and at 12 months post-randomization. The primary endpoint of STOP-HF-in-PD is the difference in left ventricular global longitudinal strain, a measure of cardiac function, after 6-months of dapagliflozin compared to placebo. For the cardiac MRI sub-study, the primary endpoint is the difference of indexed left ventricular mass after 12 months of dapagliflozin compared to placebo. Conclusions. The Renal Lifecycle Trial cardiac imaging sub-studies will generate novel data on the effects of SGLT2-inhibition on cardiac structure and function in a population with advanced CKD, in whom SGLT2-inhibitor induced cardiovascular protection remains to be established.
AB - Background. Patients with chronic kidney disease (CKD) are frequently hospitalized for heart failure. Sodium-glucose co-transporter 2 (SGLT2)-inhibitors improve cardiorenal outcomes in CKD and heart failure, at least in estimated glomerular filtration rate (eGFR) ranges 20-60 ml/min/1.73 m2, possibly through direct cardiac effects. In the cardiac imaging sub-studies of the Renal Lifecycle Trial, we aim to establish the effects of SGLT2-inhibition on cardiac structure and function in patients with advanced CKD, kidney failure and in kidney transplant recipients. Methods. In the Renal Lifecycle Trial, patients with advanced CKD (eGFR ≤25 ml/min/1.73 m2), those treated with hemodialysis or peritoneal dialysis (PD) or kidney transplant recipients (eGFR ≤45 ml/min/1.73 m2), are randomized to receive either dapagliflozin or placebo. The echocardiography sub-study (acronym: STOP-HF-in-PD) will enroll 100 PD-treated patients, who undergo echocardiography at baseline, and at 6 and 12 months post-randomization. In the cardiac magnetic resonance imaging (MRI) sub-study, 250 Renal Lifecycle Trial participants across all three groups (i.e. advanced CKD, dialysis, kidney transplant recipients), including a subset of STOP-HF-in-PD participants, will undergo cardiac MRI at baseline, and at 12 months post-randomization. The primary endpoint of STOP-HF-in-PD is the difference in left ventricular global longitudinal strain, a measure of cardiac function, after 6-months of dapagliflozin compared to placebo. For the cardiac MRI sub-study, the primary endpoint is the difference of indexed left ventricular mass after 12 months of dapagliflozin compared to placebo. Conclusions. The Renal Lifecycle Trial cardiac imaging sub-studies will generate novel data on the effects of SGLT2-inhibition on cardiac structure and function in a population with advanced CKD, in whom SGLT2-inhibitor induced cardiovascular protection remains to be established.
U2 - 10.1093/ckj/sfaf376
DO - 10.1093/ckj/sfaf376
M3 - Article
C2 - 41551843
SN - 2048-8505
VL - 19
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
IS - 1
M1 - faf376
ER -