For patients with stage 4 CKD, a similar pattern of reduced kidney, cardiovascular, and mortality risks is seen with dapagliflozin versus placebo, with no evidence of increased risks, according to a study published in the Journal of the American Society of Nephrology. Researchers examined the effect of dapagliflozin in patients with stage 4 CKD (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m2). Patients with an eGFR of 25 to 75 mL/min/1.73 m2 and urinary albumin-to-creatinine ratio of 200 to 5,000 mg/g were randomly assigned to either dapagliflozin (n = 293) or placebo (n = 33). The investigators found a 27% reduction in the primary compos- ite end point of sustained decline in eGFR of greater than or equal to 50%, end-stage kidney disease, or kidney or cardiovascular death among patients randomly assigned to dapagliflozin com- pared with placebo and statistically nonsignifi- cant reductions in the kidney, cardiovascular, and mortality end points. In the dapagliflozin and placebo groups, the declines in eGFR slope were 2.15 and 3.38 mL/min/1.73 m2/year, respective- ly. Both groups had similar rates of serious ad- verse events and adverse events of interest. “This analysis shows that the effects of dapagliflozin in patients with stage 4 CKD are similar to effects in patients with mild to moderate CKD,” a study co-author said in a statement.