Improved home BP profile with dapagliflozin is associated with amelioration of albuminuria in Japanese patients with diabetic nephropathy: the Yokohama add-on inhibitory efficacy of dapagliflozin on albuminuria in Japanese patients with type 2 diabetes study (Y-AIDA study)

Autor: Yoshinobu Kondo, Masaaki Hanaoka, Taku Yamada, Toshihiro Misumi, Yuzuru Ito, Saho Hosokawa, Kazuki Orime, Tomoko Shibasaki-Kurita, Kengo Azushima, Taishi Yoshii, Jun Yutoh, Kazutaka Aoki, Tadashi Yamakawa, Uru Nezu Osada, Takayuki Yamada, Sho Kinguchi, Hiromichi Wakui, Kohji Inazumi, Ryu Kobayashi, Yasuo Terauchi, Kotaro Haruhara, Yusuke Kobayashi, Hiroto Sasaki, Syuji Ono, Takeharu Yamanaka, Tamio Iwamoto, Gen Yasuda, Kouichi Tamura, Kohji Ohki
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Blood Glucose
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Endocrinology
Diabetes and Metabolism
Type 2 diabetes
Diabetic nephropathy
030204 cardiovascular system & hematology
Kidney
chemistry.chemical_compound
0302 clinical medicine
Glucosides
Japan
Diabetic Nephropathies
Prospective Studies
Dapagliflozin
Original Investigation
Morning
SGLT2 inhibitor
Blood Pressure Monitoring
Ambulatory
Middle Aged
Circadian Rhythm
Treatment Outcome
Blood pressure
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Evening
Urology
Renal function
030209 endocrinology & metabolism
Young Adult
03 medical and health sciences
Internal medicine
Type 2 diabetes mellitus
medicine
Humans
Albuminuria
Benzhydryl Compounds
Sodium-Glucose Transporter 2 Inhibitors
Aged
Glycated Hemoglobin
Creatinine
business.industry
medicine.disease
Diabetes Mellitus
Type 2
chemistry
lcsh:RC666-701
business
Biomarkers
Zdroj: Cardiovascular Diabetology, Vol 18, Iss 1, Pp 1-16 (2019)
Cardiovascular Diabetology
ISSN: 1475-2840
Popis: BackgroundThe Y-AIDA study was designed to investigate the renal- and home blood pressure (BP)-modulating effects of add-on dapagliflozin treatment in Japanese individuals with type 2 diabetes mellitus (T2DM) and albuminuria.MethodsWe conducted a prospective, multicenter, single-arm study. Eighty-six patients with T2DM, HbA1c 7.0–10.0%, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min/1.73 m2, and urine albumin-to-creatinine ratio (UACR) ≥ 30 mg/g creatinine (gCr) were enrolled, and 85 of these patients were administered add-on dapagliflozin for 24 weeks. The primary and key secondary endpoints were change from baseline in the natural logarithm of UACR over 24 weeks and change in home BP profile at week 24.ResultsBaseline median UACR was 181.5 mg/gCr (interquartile range 47.85, 638.0). Baseline morning, evening, and nocturnal home systolic/diastolic BP was 137.6/82.7 mmHg, 136.1/79.3 mmHg, and 125.4/74.1 mmHg, respectively. After 24 weeks, the logarithm of UACR decreased by 0.37 ± 0.73 (P P P P = 0.0079 for systolic BP,P = 0.0415 for diastolic BP). Furthermore, the reduction in UACR after 24 weeks significantly correlated with an improvement in home BP profile, but not with changes in other variables, including office BP. Multivariate linear regression analysis also revealed that the change in morning home systolic BP was a significant contributor to the change in log-UACR.ConclusionsIn Japanese patients with T2DM and diabetic nephropathy, dapagliflozin significantly improved albuminuria levels and the home BP profile. Improved morning home systolic BP was associated with albuminuria reduction.Trial registrationThe study is registered at the UMIN Clinical Trials Registry (UMIN000018930;http://www.umin.ac.jp/ctr/index-j.htm). The study was conducted from July 1, 2015 to August 1, 2018.
Databáze: OpenAIRE
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