Relationship between dapagliflozin and urinary albumin-to-creatinine ratio in patients with diabetes mellitus and cardiovascular disease: an observational study

The potential impact of dapagliflozin on the urinary albumin-to-creatinine ratio (UACR) in patients with type 2 diabetes and cardiovascular disease remained inconclusive. We aimed to investigate the potential impact of dapagliflozin on the UACR in patients with diabetes mellitus complicated with cardiovascular disease. This is a single-center prospective observation study. Diabetic patients with cardiovascular disease were recruited at authors’ center (both outpatients and inpatients) during a period from June 2019 to November 2020. The study subjects were grouped into a dapagliflozin group (receiving dapagliflozin for at least 6 consecutive months) and a non-sodium-glucose cotransporter 2 inhibitors (SGLT2i) group (not receiving dapagliflozin or any other SGLT2i). LgUACR change at 6 months from the baseline were compared between the two groups. A total of 57 patients were enrolled during a period from June 2019 to November 2020: 35 in the dapagliflozin group versus 22 in the non-SGLT2i group. LgUACR change from the baseline was −0.07 in the dapagliflozin group, and 0.17 in the non-SGLT2i group (P = 0.021). Dapagliflozin was associated with a decrease in UACR in the univariate regression analysis but not in the analysis of covariance. Dapagliflozin may be associated with a decrease in the UACR in patients with diabetes mellitus and cardiovascular disease. In view of the limited sample size, further investigation is needed to verify these findings.