Effect of SGLT2 Inhibitors on anaemia In patients with CKD 3 & 4 secondary to Diabetic Nephropathy.

Abstract

Objective: The objective of the study is to evaluate the effect of adding dapagliflozin to standard anaemia care on hemoglobin
trajectories in stage 3–4 diabetic chronic kidney disease (CKD).
Methodology: Adults aged 40–80 years with stage 3–4 diabetic CKD, Hb <13.0 g/dL (males) or <12.0 g/dL (females), and
MCV 80–100 fL were enrolled (n=86). Participants were randomized (1:1) to Group A (dapagliflozin 10 mg daily plus oral
iron, Haemopoietin, insulin, and standard CKD care) or Group B (oral iron, Haemopoietin, insulin, and standard CKD
care). Hb and HbA1c were measured at baseline, 1, and 3 months. The primary outcome was Hb improvement at 3
months (≥1 g/dL rise from baseline or normalization to WHO thresholds).
Results: Baseline characteristics were similar between groups. Group A showed larger and earlier Hb increases than
Group B. Mean Hb change in Group A was +0.45 g/dL at 1 month and +0.96 g/dL at 3 months (both p < 0.01). Group B
experienced smaller increases (+0.08 g/dL at 1 month, p = 0.069; +0.25 g/dL at 3 months, p = 0.020). The linear mixedeffects
model demonstrated significant effects of time, treatment group, and their interaction (all p < 0.001). The predefined
primary outcome at 3 months was met in 33/43 (76.7%) participants in Group A versus 13/43 (30.2%) in Group B
(p < 0.001).
Conclusions: Adding dapagliflozin to standard anaemia management yields a larger and more sustained rise in haemoglobin.

Keywords: Dapagliflozin, SGLT2 inhibitors, Chronic kidney disease (CKD), Diabetic nephropathy, Anemia.