Abstract
BACKGROUND: Data on the effects of sacubitril/valsartan combined with dapagliflozin in non-diabetic patients with advanced chronic kidney disease (CKD) are limited. In this study, we evaluated the efficacy and safety of sacubitril/valsartan plus dapagliflozin in non-diabetic patients with advanced CKD. METHODS: A single-center, prospective cohort study was conducted in non-diabetic patients with advanced CKD who had not yet initiated renal replacement therapy. Group A included 65 patients who received combined sacubitril/valsartan and dapagliflozin therapy, while Group B consisted of 59 patients treated with sacubitril/valsartan alone. Estimated glomerular filtration rate (eGFR), proteinuria, blood pressure and serum potassium levels were assessed. RESULTS: Baseline eGFR was 36.35(31.00, 46.47) and 40.01(30.12, 45.86) mL/min/1.73m(2) in the Group A and Group B, respectively. There was significant difference in eGFR between the two groups at month 6 [30.92(25.38, 35.38) vs. 25.42(21.58, 30.27)mL/min/1.73m(2), p < 0.001]. The difference in the change in eGFR between the two groups was statistically significant (p < 0.001). Compared with sacubitril/valsartan alone, the combination of sacubitril/valsartan and dapagliflozin provided an additional significant reduction in blood pressure, attenuated the decline in eGFR, reduced proteinuria, and lowered the risk of hyperkalemia (p < 0.05). CONCLUSION: In non-diabetic patients suffering from advanced CKD, treatment with sacubitril/valsartan combined with dapagliflozin effectively controlled blood pressure, reduced proteinuria, slowed the progression of renal dysfunction, and did not increase the risk of adverse events, indicating a favorable safety profile.