Status:
COMPLETED
GLUcose Transport and REnalPROtection in Chronic Kidney Disease
Lead Sponsor:
IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
Collaborating Sponsors:
AstraZeneca
Conditions:
Chronic Kidney Disease
Diabetes Mellitus, Type 2
Eligibility:
All Genders
18-75 years
Phase:
PHASE2
PHASE3
Brief Summary
This is a single-center, double blind, randomized, parallel-arms study designed to investigate the effects of a six-month treatment with the SGLT2i dapagliflozin on markers of kidney senescence, infla...
Detailed Description
In the run-in phase, clinical parameters will be optimized by the use of metformin/repaglinide and or RAAS-I on the basis of the presence/absence of a diagnosis of diabetes. Subsequently, patients wil...
Eligibility Criteria
Inclusion
- Albuminuria defined as urinary albumin:creatinine ratio ≥ 25 mg/g (or protein:creatinine ratio ≥ 30 mg/g) or albuminuria \> 30 mg/24h
- eGFR \> 25 and \< 75 ml/minute 1.73m2
- BMI between 19 kg/m2 and 30 kg/m2
- Treatment with an ACE inhibitor and/or ARB at the maximum tolerated (for the individual subject) dose. The maximum tolerated dose for an individual subject may be less than the maximum labeled dose or may be zero if the medical reason is documented.
- Mean systolic and diastolic blood pressure (determined as the average of three replicates) must be \< 180/90mmHg
- Pre-menopausal women of child-bearing potential 1 must have a negative pregnancy test performed before the inclusion in the study V e r s i o n 6 . 0 - P a g . 10 \| 32
- Willingness to participate in the study (signed informed consent)
- IN PARTICIPANTS WITH Type 2 Diabetes
- Clinical diagnosis of T2DM for at least 1 year
- Hemoglobin A1c (HbA1c) value of \< 9.5%
- Patients treated only with metformin and/or repaglinide
- A diagnosis of Diabetic Nephropathy at renal biopsy made not more than 6 months before the screening visit (only for the subgroup of patients candidated to the second kidney biopsy)
- Proteinuria \> 1g/24h (only for the subgroup of patients candidated to the second kidney biopsy)
- Hemoglobin A1c (HbA1c) value of \> 6.5% (only for patients candidated to the second kidney biopsy) In PARTICIPANTS Without Type 2 Diabetes
- diagnosis of hypertension for at least 5 years
Exclusion
- Type 1 Diabetes
- Hemoglobin A1c (HbA1c) value of \> 9.5% during the Screening period (based on central laboratory measurement).
- The need for an adjunctive drugs on top on metformin and repaglinide
- Hemoglobin A1c (HbA1c) value of \< 6.5% only for patients candidated to the second kidney biopsy
- Estimated glomerular filtration rate \< 25 or \> 75 ml/min/1.73m2 (according to the CKD-EPI) at screening
- Untreated urinary or genital infection at screening and follow-up
- Clear signs of volume depletion
- Symptomatic hypotension, or systolic blood pressure \< 90 or non-controlled hypertension
- History of alcohol or drug abuse, anuria, dialysis, or acute kidney injury/acute renal failure in the 3 months prior to Screening Period
- Heart, liver or kidney transplant V e r s i o n 6 . 0 - P a g . 11 \| 32
- Acute coronary syndrome, stroke, or transient ischemic attack within 3 months prior to informed consent
- Liver disease, defined by serum levels of alanine aminotransferase, aspartate aminotransferase, or alkaline phosphatase above 3 x upper limit of normal (ULN) during screening
- Planned cardiac surgery or angioplasty within 3 months
- Cancer or medical history of cancer (except for basal cell carcinoma) within the last 5 years
- Treatment with anti-obesity drugs 3 months prior to informed consent or any other treatment at time of screening leading to unstable body weight (e.g. surgery, aggressive diet regimen, etc.)
- SGLT2i treatment in the 10 weeks before the Screening Period
- Treatment with systemic steroids at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent
- Any uncontrolled endocrine disorder except T2DM
- Women who are pregnant or breastfeeding
- Pre-menopausal women of child bearing potential who are not willing to employ effective contraception according to 2007 CTFG Recommendations related to contraception and pregnancy testing in clinical trials from screening for all the duration of the study
- Patients with a known hypersensitivity to Dapagliflozin or other SGLT2- inhibitors, including hypersensitivity to excipients (e.g. lactose)
- History of pancreatitis, or pancreatic surgery, diabetic ketoacidosis
- Prior lower extremity amputation or current threat of amputation (eg, lower extremity ulcer and peripheral artery disease)
- History of severe hypoglycaemia and hypoglycaemia unawareness.
- Contraindication to MRI
Key Trial Info
Start Date :
April 13 2021
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
September 30 2024
Estimated Enrollment :
34 Patients enrolled
Trial Details
Trial ID
NCT05998837
Start Date
April 13 2021
End Date
September 30 2024
Last Update
March 28 2025
Active Locations (1)
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1
IRCCS Ospedale Policlinico San Martino
Genova, GE, Italy, 16132