A study published in the Clinical Journal of the American Society of Nephrology (CJASN) disclosed that the combined effects of SGLT2 and renin-angiotensin-aldosterone system (RAAS) inhibitor therapy could significantly lower the risk of kidney failure or death in patients with albuminuric, nondiabetic chronic kidney disease.

An analysis based on trial-level estimations stated that angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) were estimated to extend renal failure-free survival time by years.

The clinical trial data included in the current study were taken from Ramipril Efficacy in Nephropathy (REIN) trial, the Guangzhou trial from China, and the Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial. The participants were albuminuric and nondiabetic CKD and were treated with ramipril, benazepril, and dapagliflozin (Farxiga). On an average, participants in the trial were 45 to 62 years old, with mean estimated glomerular filtration rates of 20 to 43 mL/min/1.73 m2 and median urine albumin-creatinine ratios of 949 to 1,499 mg/g.

The results showed that with combination therapy, the estimated survival free from the primary composite endpoint for a patient 50 years of age and older was estimated to be 17.0 (95% confidence interval, 12.4 to 19.6) years, compared to 9.6 years (95% confidence interval, 8.4 to 10.7) years without treatment with any of these agents. Thus combining these medications has been found to reduce the probability of a composite primary endpoint—a doubling of serum creatinine—kidney failure, or death—by 65% compared to receiving no treatment.

These findings show the possibility and the ability to delay or even prevent renal failure and early mortality, which would reduce the burden of CKD consequences if currently available medications are used properly.

(Source: https://www.medpagetoday.com/nephrology/esrd/101909)