{"id":"94a9a074fafb","type":"article","url":"https://hartvaat.nl/2025/06/01/dapagliflozine-bij-acuut-gedecompenseerd-hartfalen-en-nierfunctie-rct/","title":"Dapagliflozine bij acuut gedecompenseerd hartfalen en nierfunctie: RCT","title_en":"Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","bisoprolol","canagliflozine","dapa-hf","dapagliflozine","empagliflozine","emperor-trials","hfpef","hfref","sglt2-remmers","step-hfpef"],"journal":"ESC heart failure","doi":"10.1002/ehf2.15212","source_url":"https://doi.org/10.1002/ehf2.15212","authors":["Shodai Kawanami","Yasuyuki Egami","Masaru Abe","Mizuki Osuga","Hiroaki Nohara","Kohei Ukita","Akito Kawamura","Koji Yasumoto","Naotaka Okamoto","Yasuharu Matsunaga-Lee","Masamichi Yano","Masami Nishino"],"significance":6,"published":"2025-06-01","source_date":"2025-06-01","image":"","kennis":[],"congress":"","summary_en":"This randomized trial confirmed that dapagliflozin does not worsen renal function when added for acute decompensated heart failure, providing safety data for early SGLT2 inhibitor initiation during AHF hospitalization.","created":"2026-07-03T10:31:38Z","updated":"2026-07-03T18:39:16Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial onderzocht of dapagliflozine de nierfunctie verslechtert bij acuut gedecompenseerd hartfalen. SGLT2-remming was veilig en verergerde de nierfunctie niet, wat toevoeging aan acute HF-therapie ondersteunt.","abstract_original":"AIMS: Dapagliflozin (DAPA), a sodium-glucose co-transporter 2 inhibitor, has been shown to reduce cardiovascular mortality among patients with chronic heart failure. We aimed to evaluate the impact on a worsening renal function (WRF) by adding DAPA as compared to standard decongestive therapy with loop diuretics alone. METHODS AND RESULTS: We enrolled 114 consecutive acute decompensated heart failure (ADHF) patients with a left ventricular ejection fraction (LVEF) of less than 50%. The patients were prospectively randomized to be assigned either to DAPA group who received DAPA at a dose of 10 mg once daily within 24 h after admission or conventional therapy group (CON group) who received loop diuretics alone. All patients were adjusted by increasing or decreasing the loop diuretic by 10 mg to maintain a 1-2 mL/kg/h urine output. The primary endpoint was the incidence of WRF, which was defined as an increase in the serum creatinine of ≥0.3 mg/dL from baseline. The median age of the patients was 77 [interquartile range (IQR): 64, 85] years, 35% were female and the median LVEF was 33 [IQR: 28, 38] %. There was no significant difference in the incidence of WRF between the two groups (16.1%, n = 9 vs. 12.1%, n = 7, P value = 0.54). The total dose of loop diuretics through day 7 was lower in the DAPA group than CON group (184 ± 79.5 mg vs. 214 ± 66.5 mg, P value = 0.03). CONCLUSIONS: This randomized prospective trial revealed the addition of DAPA within 24 h after admission reduced the diuretic dose without WRF."}