MON-302 ADMINISTRATION OF DAPAGLIFLOZIN IN TYPE 2 DIABETES MELLITUS PATIENTS WITH CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW

Abstract

The increasing number of diabetes mellitus has led to an increase in the incidence of chronic kidney disease (CKD). Roughly, a third of all patients with diabetes mellitus also develop CKD as the disease progresses. Dapagliflozin, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, is the latest agent used in type 2 diabetes mellitus patients. The drug lower blood sugar levels by prevent glucose reabsorption in the proximal renal tubule. Inhibition of sodium reabsorption, on the other hand, manifested as an acute reduction in glomerular filtration rate (GFR) and albuminuria. This systematic review aims to analyze the clinical impact of dapagliflozin uses in type 2 diabetes patients with CKD. Interventional studies related to dapaglifozin administration in type 2 diabetes mellitus patients with chronic kidney disease were reviewed systematically. Inaugural literature searching was finished in four scientific databases (PubMed, EbscoHost, ProQuest, and Cochrane) using specific medical subheading (MeSH) terms and filters. Articles screened and selected by three authors independently to prevent bias. Studies that were relevant included to be further reviewed using tools provided by Centre for Evidence-based Medicine (CEBM). Two related articles were included in the review. Dapagliflozin was administered in a total of 441 type 2 diabetes mellitus patients with stages 3a-4 CKD. Study period ranged between 24-weeks to 104-weeks. Investigation reveals dapagliflozin considered as safe and effective in moderate renal impairment. However, the capacity of the drug to lower blood glucose levels tend to decrease in severe impaired renal function. This review draws to the conclusion that dapagliflozin administration may not improve glycemic index in diabetes mellitus patients with severe chronic kidney disease.