The Safety of Dapagliflozin in Hemodialysis Patients With Heart Failure

Not Applicable

• Conditions: Hemodialysis Complication
• Interventions: Drug: Dapagliflozin 10Mg Tab

• Registration Number: NCT05141552
• Lead Sponsor: RenJi Hospital

Brief Summary

SGLT2 inhibitor is a new type of sugar-lowering medicine and is recommended to treat heart failure. eGFR lower than 30ml/min/1.73M2 is contraindication of SGLT2 inhibitor. Heart failure is one of the most frequency CVD events for hemodialysis patients. But hemodialysis patient is unable to be treated with SGLT2 inhibitors as the contraindication. However, solute and fluid clearance are dependent on dialysis, but not renal function in hemodialysis patients. There is no data of SGLT2 inhibitor on hemodialysis patients. The aim of the present study is evaluate the safety of Dapagliflozin in hemodialysis patients with heart failure.

This is a randomized, control, open study. 20 hemodialysis patients with heart failure will be recruited. 10 of 20 subjects will be treated with dapagliflozin 10mg everyday for 12 weeks. The primary outcome is the number of patients with hypoglycemia or urinary infection. The secondary outcomes is the changes of NT-.

Detailed Description

Evaluate the safety of dapagliflozin in hemodialysis patients with heart failure is the main purpose of this study. and Estimate the change of NT-proBNP is the secondary purpose.

This is a randomized, control and open study.

The including criteria are 1. Understand the present study and sign informed consert 2. Age is between 18 and 70 3. 2 or 3 times blood purification treatments (inclusion hemodialysis, hemofiltration, hemoperfusion) every week, 4. Blood purification treatment more than 3 month 5. Using AV fistula or artificial vascular access 6. With chronic heart failure (NYHC II-IV), and NT-proBNP\>11500 or BNP\>500 7. ARNI or RAS inhibitor or Aldosterone inhibitors treatment for at least 4 weeks with a stable dose The exclusion criteria are 1.Blood purification less than 3 month 2.With fluid overload and URR\<50% 3.Have severe hypoglycemia (more than 2 events with 4 weeks prior to sign concert information) 4.Have severe hypotension (blood pressure \<90/60mmHg more than 3 times with 4 weeks prior to sign concert information) 5.Have acute pulmonary edema 6.Have ketoacidosis 7.Have active pyelnephritis and symptomatic lower urinary infection 8.Subject is pregnant , is breast feeding 9.Subject has known SGLT2 inhibitor allergy or intolerance adverse reactions 10.Subject is currentluy enrolled in or has not yet completed at least 30days since ending other investigational device or drug trials 11.Investigator believe subject is not suitable for this study

Subjects will divide into two groups. Dapa group will be treated with dapagliflozin 10mg qd and standard anti-heart failure therapy. Control group will be treated with standard anti-heart failure therapy.

The primary outcome is the number of patients with hypoglycemia or urinary tract infection. The secondary outcome is the change of NT-proBNP

Study Timeline

• Study First Submitted: 2021-11-07
• Study First Submitted QC: 2021-11-20
• Study First Posted: 2021-12-02
• Study Start: 2022-01-03
• Status Verified: 2022-05
• Last Update Submitted: 2022-05-07
• Last Update Posted: 2022-05-10
• Primary Completion: 2022-07-31
• Study Completion: 2022-07-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

1. Understand the present studyAgree and sign informed consert
2. Age is between 18 and 70 Men or women ≧18 years and <70 years of age at screening
3. Treated with maintenance blood purification 2 or 3 times blood purification treatments (including hemodialysis, hemofiltration, hemoperfusion) every week2 or 3 times a week,
4. Blood purification treatment more than 3 month before randomization
5. Blood purification by uUsing AV fistula or artificial vascular access
6. DiagnosisWith chronic heart failure (NYHC II-IV), and NT-proBNP>11500 or BNP>500
7. ARNI or RAS inhibitor or Aldosterone inhibitors or beta receptor blocker treatment for at least 4 weeks with a stable dose.

Exclusion Criteria

1. Blood purification less than 3 month
2. With fluid overload and URR<50%
3. Have severe hypoglycemia (more than 2 events with 4 weeks prior to sign concert information)
4. Have severe hypotension (blood pressure <90/60mmHg more than 3 times with 4 weeks prior to sign concert information)
5. Have acute pulmonary edema
6. Have ketoacidosis
7. Have active pyelnephritis and symptomatic lower urinary infection
8. Subject is pregnant , is breast feeding
9. Subject has known SGLT2 inhibitor allergy or intolerance adverse reactions
10. Subject is currentluy enrolled in or has not yet completed at least 30days since ending other investigational device or drug trials
11. Investigator believe subject is not suitable for this study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
dapa group	Dapagliflozin 10Mg Tab	subjects will be treated with dapagliflozin (10mg per day) and standard anti-heart failure therapy (including RAS inhibitors, beta-blocker, Aldosterone inhibitors)

Primary Outcome Measures

Name	Time	Method
the number of patients with hypoglycemia or urinary tract infection	12 weeks	the number of patients with hypoglycemia or urinary tract infection

Secondary Outcome Measures

Name	Time	Method
Change of NT-proBNP	12 weeks	Change of NT-proBNP

Trial Locations

Locations (1)

Department of nephrology , Renji Hospital, Shanghai Jiao Tong University School of Medicine; 🇨🇳 Shanghai, Shanghai, China