{"id":"b58ac0f65a12","type":"article","url":"https://hartvaat.nl/2026/11/02/dapagliflozin-vertraagt-progressie-van-prefrailty-naar-frailty-bij-hypertensie-e/","title":"Dapagliflozin vertraagt progressie van prefrailty naar frailty bij hypertensie en CKD — DAPA-FORTRESS","title_en":"Dapagliflozin attenuates progression from prefrailty to frailty in patients with hypertension and chronic kidney disease.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"The Journal of clinical investigation","doi":"10.1172/JCI205416","source_url":"https://doi.org/10.1172/JCI205416","authors":["Pasquale Mone","Davide Viggiano","Antonella Pansini","Maria Virginia Soldovieri","Giada Sabatelli","Valeria Visco","Gaetano Macina","Eugenio Boccalone","Michele Ciccarelli","Giuseppe Martinelli","Marco Di Mauro","Carmine Vecchione","Maria Morgante","Fahimeh Varzideh","Germano Guerra","Gaetano Santulli"],"significance":4,"published":"2026-11-10","source_date":"2026-11-02","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/diabetische-nefropathie/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"In a matched cohort of 105 older patients (>65 years) with hypertension and chronic kidney disease, dapagliflozin use was independently associated with a substantially lower risk of progressing from pre-frailty to frailty over one year (OR 0.130; 95% CI 0.045–0.381; p < 0.001). The study also confirmed that worse renal function and higher albuminuria correlate with poorer physical performance. These observational findings suggest that SGLT2 inhibitors may help preserve functional capacity in high-risk cardiorenal patients, supporting their broader use in older adults with metabolic and renal comorbidities.","created":"2026-11-03T02:41:31Z","updated":"2026-11-03T02:41:31Z","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":"In een gematcht cohort van 105 oudere patiënten (>65 jaar) met hypertensie en chronische nierziekte (CKD) werd onderzocht of dapagliflozin de progressie van prefrailty naar frailty beïnvloedt. Na één jaar follow-up was het gebruik van dapagliflozin onafhankelijk geassocieerd met een sterk gereduceerd risico op frailty-progressie (OR 0,130; 95% BI 0,045–0,381; p < 0,001), terwijl een lagere eGFR en hogere albuminurie samenhangen met slechtere fysieke prestaties. Deze bevindingen ondersteunen de rol van SGLT2-remmers bij het behoud van functioneel vermogen in deze kwetsbare groep, wat relevant is voor de cardiorenale zorg en ouderenzorg.","abstract_original":"BACKGROUNDChronic kidney disease (CKD) and hypertension share common pathophysiological pathways contributing to vascular damage, endothelial dysfunction, and physical decline, particularly in older adults with prefrailty. To evaluate the relationship among renal injury, physical performance, and frailty progression in hypertensive older adults with CKD and assess whether dapagliflozin associates with reduced frailty progression, we designed the study DAPA-FORTRESS (DAPAgliflozin and Frailty prOgression in hypeRTension and chRonic kidnEy diSeaSe).METHODSWe enrolled 135 prefrail hypertensive patients with CKD aged >65 years and followed them for 1 year. After coarsened exact matching, our balanced cohort had 105 patients (52 dapagliflozin). Associations between albuminuria, estimated glomerular filtration rate (eGFR), and physical performance were analyzed using correlation and regression models. Effect of dapagliflozin on frailty progression was evaluated using multivariable logistic regression.RESULTSA significant inverse association between gait speed and albuminuria (r2 = 0.48, P < 0.0001) and significant positive linear association between gait speed and eGFR (r2 = 0.18; P < 0.0001) were observed. Patients with eGFR <60 mL/min/1.73 m2 exhibited significantly worse physical performance than those with higher eGFR (P = 0.0003). In adjusted analyses, receiving dapagliflozin was independently associated with lower odds of progressing to frailty at 1 year (OR = 0.130; CI 0.045-0.381; P < 0.001).CONCLUSIONIn older hypertensive patients with CKD, greater renal injury is associated with worse physical performance, while dapagliflozin use reduces the risk of frailty progression. These findings indicate a potential protective role of sodium-glucose cotransporter 2 inhibition in mitigating functional decline in this high-risk population.FUNDINGNIH: National Heart, Lung, and Blood Institute (R01-HL146691), National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK123259); American Heart Association (AHA- 24IPA1268813, AHA-22-915561, AHA-24-1195524)."}