{"id":31466,"date":"2026-08-07T04:11:00","date_gmt":"2026-08-06T20:11:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31466"},"modified":"2026-08-07T05:37:59","modified_gmt":"2026-08-06T21:37:59","slug":"31466","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31466","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u8fbe\u683c\u5217\u51c0\u4e0e\u5fc3\u810f\u624b\u672f\u540e\u7684\u6025\u6027\u80be\u635f\u4f24"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial<\/h1>\n\n\n\n

Maartina J. P.\u00a0Oosterom-Eijmael,\u00a0Abraham H.\u00a0Hulst,\u00a0Nelson P. Monteiro\u00a0de Oliveira,\u00a0et al<\/h3>\n\n\n\n

JAMA Published Online:\u00a0July\u00a030,\u00a02026<\/h3>\n\n\n\n

doi: 10.1001\/jama.2026.9268<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Among patients undergoing elective cardiac surgery, does dapagliflozin, initiated 1 day prior to surgery, reduce acute kidney injury at 7 days after surgery?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial that included 784 patients undergoing elective cardiac surgery, compared with placebo, dapagliflozin significantly reduced the incidence of postoperative acute kidney injury during the 7 days following surgery (52% vs 28%).<\/p>\n\n\n\n

Meaning<\/strong>  In patients undergoing elective cardiac surgery, these findings support prescribing dapagliflozin to prevent acute kidney injury during the 7-day postoperative period.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>\u00a0\u00a0Two percent to 50% of patients undergoing elective cardiac surgery experience acute kidney injury (AKI) postoperatively. Medications to prevent AKI after elective cardiac surgery have not been identified.<\/p>\n\n\n\n

Objective<\/strong>  In patients undergoing elective cardiac surgery, to evaluate whether initiating dapagliflozin 1 day prior to surgery reduces the incidence of AKI at 7 days after cardiac surgery, compared with placebo.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Multicenter, double-blind, placebo-controlled randomized clinical trial conducted at 2 academic medical centers and 5 nonacademic hospitals in the Netherlands. Eligible participants were adults undergoing elective cardiac surgery. Enrollment occurred between June 8, 2023, and January 27, 2025. Final follow-up occurred May 16, 2025.<\/p>\n\n\n\n

Intervention<\/strong>  Patients were randomized 1:1 to receive either dapagliflozin (10 mg orally; n\u2009=\u2009392) or placebo once daily (n\u2009=\u2009392), beginning on the day before surgery and continuing through the second postoperative day (total of 4 doses).<\/p>\n\n\n\n

Main Outcome and Measure<\/strong>  The primary outcome was the between-group difference in AKI (defined as an increase in serum creatinine level by at least 0.3 mg\/dL [26.5 \u00b5mol\/L] within 48 hours after surgery, a 1.5-fold creatinine increase within 7 days of surgery, or urine output less than 0.5 mL\/kg\/h for 6 to 12 hours according to Kidney Disease: Improving Global Outcomes criteria) during the first 7 postoperative days.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Of 784 participants enrolled, 778 (99%) completed follow-up testing (median age, 68 [61-74] years; 76% male; 97% White; median body mass index, 27 [IQR, 25-30]; and median estimated glomerular filtration rate, 80 [IQR, 67-89] mL\/min\/1.73 m2<\/sup>). Compared with placebo, dapagliflozin reduced the incidence of AKI (28% vs 52%; relative risk, 0.54 [95% CI, 0.45-0.65];\u00a0P<\/em>\u2009<\u2009.001) over 7-day follow-up after surgery. Atrial fibrillation and reoperation were the most frequent adverse events. The incidence of atrial fibrillation was 45% (176\/392) in the dapagliflozin group vs 45% (176\/392) in the placebo group, and the incidence of reoperation was 11% (43\/392) vs 10% (39\/392), respectively.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In patients undergoing elective cardiac surgery, 4 doses of dapagliflozin, beginning the day before surgery, reduced the incidence of AKI during the 7-day postoperative period.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT05590143<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Dapagliflozin and Acute Ki […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31466"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31466"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31466\/revisions"}],"predecessor-version":[{"id":31469,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31466\/revisions\/31469"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31466"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31466"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31466"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}