Diabetes drug canagliflozin slows advanced kidney disease

Article written by Bruce Sylvester

The diabetes drug canagliflozin, which has already shown efficacy in slowing kidney disease, is also effective among patients with advanced kidney disease.

Researchers reported these findings in the December 2020 issue of CJASN/Clinical Journal of the American Society of Nephrology.

“Until recently, there were limited data regarding the use of SGLT2 inhibitors in patients with compromised kidney function, and there were few treatment options for this patient population who are at a high risk for developing kidney failure,” said investigator George Bakris, M.D., professor of medicine at the University of Chicago School of Medicine. “This research suggests that canagliflozin is a safe treatment option for this patient population that can help to slow the progression of kidney disease.”

Bakris and colleagues in CREDENCE (The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) made a post hoc analysis of data from 174 study subjects who had been diagnosed with advanced chronic kidney disease  (CKD), measured as an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2, at the start of them CREDENCE trial.

The researchers reported that canagliflozin-treated subjects with advanced CKD achieved a slowdown of CKD progression compared with placebo-treated subjects, with a 66% difference in average eGFR declines.

Notably, the effects of canagliflozin treatment on kidney, cardiovascular, and mortality outcomes among subjects with advanced CKD were similar to the same outcomes among those with less advanced CKD. The authors concluded, “This post hoc analysis suggests canagliflozin slowed progression of kidney disease, without increasing AKI [acute kidney injury], even in participants with eGFR <30 ml/min per 1.73 m².