Dapagliflozin and Acute Kidney Injury Following, Cardiac Surgery: A Randomized Clinical Trial

In this Dutch multicenter, double-blind trial, 784 adults undergoing elective cardiac surgery received dapagliflozin 10 mg (n=392) or placebo (n=392), starting one day preoperatively for four doses. Acute kidney injury within seven days occurred in 28 percent versus 52 percent, respectively (relative risk 0.54, 95 percent confidence interval [CI] 0.45–0.65; p<0.001). The median age was 68 years, 76 percent were male, and the median estimated glomerular filtration rate was 80 mL/min/1.73 m². Atrial fibrillation occurred in 45 percent of both groups; reoperation occurred in 11 percent of the dapagliflozin group versus 10 percent of the placebo group. Perioperative dapagliflozin substantially reduced postoperative seven-day acute kidney injury without increasing major adverse events.