{"id":"d6a6e0bbd4b1","type":"article","url":"https://hartvaat.nl/2026/05/05/dapa-hd-eerste-gerandomiseerde-studie-naar-dapagliflozin-bij-hemodialyse-patient/","title":"DAPA-HD: eerste gerandomiseerde studie naar dapagliflozin bij hemodialyse-patiënten — opzet en achtergrond","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","dapa-hf","dapagliflozine","dubbele-trombocytenremming","fidelio-dkd","figaro-dkd"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag104","source_url":"https://doi.org/10.1093/eschf/xvag104","authors":["Thomas A Zelniker","Christopher Paschen","Christopher Mann","Manfred Eigner","Hildegard Hafner-Gießauf","Josef Kletzmayr","Matthias Lorenz","Bernhard Ludvik","Thomas Stulnig","Ingmar Waller","Johannes Werzowa","Sebastian Hödlmoser","Christian Hengstenberg","Rainer Oberbauer","Manfred Hecking"],"significance":5,"published":"2026-06-29","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/transthoracale-echocardiografie/","https://hartvaat.nl/kennis/farmacologie/betablokkers-farmacologie/"],"congress":"","summary_en":"Design of the academic multicenter, double-blind, placebo-controlled DAPA-HD trial (NCT05179668) in 220 patients with kidney failure on maintenance haemodialysis. Background: SGLT2 inhibitors reduce cardiovascular events across a wide range of kidney function, but evidence is lacking for patients on haemodialysis. Stratified block randomisation by patient-reported residual urine volume. Primary outcome is change in left ventricular mass index (echocardiographic) at 6 months. A prespecified subgroup analysis compares patients with residual urine output >200 mL/24 h versus ≤200 mL/24 h. Secondary outcomes: additional echocardiographic parameters, biomarkers, quality of life, and clinical events. The first trial to specifically address the cardiovascular and haemodynamic effects of dapagliflozin in dialysis patients — will close an important evidence gap.","created":"2026-07-03T10:33:08Z","updated":"2026-07-03T18:39:37Z","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":"Opzet van de academische multicenter dubbelblinde placebo-gecontroleerde DAPA-HD trial (NCT05179668) bij 220 patiënten met terminaal nierfalen op chronische hemodialyse. Achtergrond: SGLT2-remmers verlagen CV-events over een breed bereik van nierfunctie, maar evidence ontbreekt voor patiënten op hemodialyse. Stratificatie via blok-randomisatie op patient-gerapporteerde resterende urineproductie. Primaire uitkomst is verandering in linkerventrikelmassa-index (echocardiografisch) na 6 maanden. Vooraf gespecificeerde subgroepanalyse vergelijkt patiënten met residuele urineproductie >200 mL/24 u versus ≤200 mL/24 u. Secundaire uitkomsten: aanvullende echocardiografische parameters, biomarkers, kwaliteit van leven en klinische events. Eerste trial die specifiek de cardiovasculaire en hemodynamische effecten van dapagliflozin onderzoekt bij dialyse-patiënten — gaat een belangrijke evidence-gap dichten.","abstract_original":"INTRODUCTION: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) reduce cardiovascular events across a wide range of kidney function, including advanced stages of chronic kidney disease, but evidence for their efficacy in patients with kidney failure on haemodialysis is lacking. The underlying mechanisms remain incompletely understood, and whether cardiovascular benefits depend on residual kidney function is unknown. STUDY DESIGN: The Dapagliflozin in Hemodialysis (DAPA-HD) trial (NCT05179668) is an academic, multicentre, randomized, double-blind, placebo-controlled trial designed to assess the cardiovascular effects of dapagliflozin in 220 patients with kidney failure receiving haemodialysis. Stratified block randomization was based on patient-reported residual urine volume. The primary endpoint is the change in left ventricular mass indexed to body surface area using echocardiography after 6 months of treatment. A prespecified subgroup analysis will compare treatment effects between patients with residual urine output >200 ml/24 h versus ≤200 ml/24 h. Secondary endpoints include additional echocardiographic assessments, changes in biomarker concentrations, quality of life, and clinical events. DISCUSSION: The DAPA-HD trial is the first trial specifically evaluating the cardiovascular and haemodynamic effects of dapagliflozin in patients with kidney failure receiving maintenance haemodialysis with and without residual urine outputs."}