#3254 Effect of dapagliflozin on arterial stiffness and cognitive impairment in patients with chronic kidney disease
Bibliographic record
Abstract
Abstract Background and Aims Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new class of antidiabetic agents that inhibit reabsorption of glucose and sodium in the proximal convoluted tubule. Many clinical studies have demonstrated their cardioprotective and nephroprotective effects in patients with chronic kidney disease (CKD). However, data regarding their effects on arterial stiffness and cognitive function remain rather limited. Method We studied 24 consecutive patients with CKD (stages 1–4), in whom dapagliflozin, 10mg once daily, was added to their therapeutic regimen. Their blood pressure was controlled by using perindopril and amlodipine, with appropriate dose adjustments when necessary. The patients were followed for a period of 3 months. Arterial stiffness was measured by means of pulse wave velocity (PWV) with the use of SphygmoCor Cardiovascular Management System (CVMS; AtCor Medical Pty Ltd, Sydney, New South Wales, Australia). Meanwhile, central arterial pressure waveforms were recorded. Concurrently, the Montreal Cognitive Assessment (MoCA) test was administered to evaluate the patients' cognitive function both at baseline and after 3 months of treatment with dapagliflozin. Baseline patient characteristics are presented in Table 1. Results At 3-month follow-up, there was a significant reduction in peripheral systolic blood pressure (pSBP) compared to baseline (129.83 vs 140.91 mmHg respectively, P < 0.001), in peripheral diastolic blood pressure (pDBP) (69.87 vs 77.58 mmHg, P < 0.001), in central systolic blood pressure (cSBP) (146.20 vs 156.25 mmHg, P < 0.001), and in central diastolic blood pressure (cDBP) (82.04 vs 89.58 mmHg, P = 0.007) (Table 2). Dapagliflozin administration also resulted in a statistically significant decrease in PWV by 1.457 (P < 0.001). Additionally, it was observed that increased values of arterial stiffness were associated with worse patient performance on the MoCA test (P = 000). After 3 months of dapagliflozin treatment, a statistically significant improvement by 1.33 was evident in the MoCA test performance (MOCA at baseline 1.54, at 3 months 1.13. (P < 0.001). Conclusion In our small cohor of patients with stage 1-4 CKD, the addition of 10 mg of dapagliflozin seems to cause reductions in both arterial stiffness and blood pressure over a period of 3-month treatment. During the same time interval, dapagliflozin seems to improve cognitive function, as evidenced by improvement in the MoCA test performance. Further studies of longer duration and of larger sample sizes are warranted in order to validate these initial promising observations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".