# Dapagliflozine bij acuut gedecompenseerd hartfalen en nierfunctie: RCT

*geplaatst 2025-06-01 · Hartfalen · ESC heart failure · doi 10.1002/ehf2.15212 · https://hartvaat.nl/2025/06/01/dapagliflozine-bij-acuut-gedecompenseerd-hartfalen-en-nierfunctie-rct/*

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.

## English: Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: ESC heart failure, https://doi.org/10.1002/ehf2.15212. Bijgewerkt 2026-07-03T18:39:16Z. 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.