Table 1: Benefits of Dapagliflozin in Heart Failure Management

Benefit	Description
Reduced Hospitalizations	Decreased rates of hospital admissions for heart failure
Cardiovascular Mortality	Lower risk of cardiovascular death
Diuretic Sparing Effect	Reduced need for high doses of loop diuretics
Renal Protection	Mitigates worsening renal function

Analyzing Worsening Renal Function in Heart Failure Patients

Worsening renal function is a common complication in patients with heart failure, particularly in those receiving diuretic therapy. The mechanisms behind WRF in this population are multifactorial, including hemodynamic changes and neurohormonal activation. Diuretics, while essential for fluid management, can result in renal hypoperfusion and acute kidney injury if not carefully monitored (Kawanami et al., 2025).

In a randomized controlled trial assessing the effects of dapagliflozin in patients with ADHF, it was found that dapagliflozin did not significantly reduce the incidence of WRF compared to standard diuretic therapy alone (Kawanami et al., 2025). This suggests that dapagliflozin may offer a safer alternative by allowing for lower diuretic doses while maintaining effective decongestion.

Table 2: Incidence of Worsening Renal Function in ADHF Patients

Treatment Group	Incidence of WRF (%)	Total Patients
Dapagliflozin	16.1	56
Loop Diuretics	12.1	58

Study Design and Patient Demographics in the Research

The study conducted by Kawanami et al. (2025) enrolled 114 patients with acute decompensated heart failure and a left ventricular ejection fraction (LVEF) of less than 50%. Participants were randomly assigned to receive either dapagliflozin or conventional loop diuretic therapy. The primary endpoint was the incidence of worsening renal function, defined as an increase in serum creatinine of ≥0.3 mg/dL from baseline within 7 days of admission.

The median age of participants was 77 years, with 35% being female. Patients presented with a median LVEF of 33%, indicative of significant cardiac dysfunction. The findings from this research highlighted the importance of monitoring renal function and exploring alternative therapies to improve patient outcomes in heart failure.

Key Findings: Dapagliflozin’s Effect on Renal Function and Diuretic Use

The key findings from the study revealed no significant difference in the incidence of WRF between the dapagliflozin and loop diuretic groups. However, the total dose of loop diuretics administered over the first seven days was lower in the dapagliflozin group, indicating that the addition of dapagliflozin allowed for better management of fluid overload with potentially lower renal risk (Kawanami et al., 2025).

Furthermore, the study highlighted dapagliflozin’s role in promoting diuresis while preserving renal function, thus supporting its use in heart failure management. This research reinforces the need for ongoing exploration of SGLT2 inhibitors in heart failure, particularly in patients at risk for WRF.

Table 3: Comparison of Diuretic Use in Treatment Groups

Group	Total Diuretic Dose (mg)	P-value
Dapagliflozin	184 ± 79.5	0.03
Loop Diuretics	214 ± 66.5

References

Brahmbhatt, D. H., Scolari, F. L., Fung, N. L., Otsuki, M., Lawler, P. R., Ross, H. J., Kuzmanov, U., Gramolini, A. O., Luk, A. C., & Billia, F. (2025). Heart failure decompensation with cardiogenic shock exhibits distinct sequential inflammatory profiles. ESC Heart Failure, 12, 2077–2086. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12055340/
Kawanami, S., Egami, Y., Abe, M., Osuga, M., Nohara, H., Ukita, K., Kawamura, A., Yasumoto, K., Okamoto, N., Matsunaga‐Lee, Y., Yano, M., & Nishino, M. (2025). Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure. ESC Heart Failure, 12, 2023–2033. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12055397/

FAQ

What is Acute Decompensated Heart Failure?
Acute decompensated heart failure is a sudden worsening of the symptoms of heart failure, requiring immediate medical attention, often leading to hospitalization.

How does Dapagliflozin help in heart failure management?
Dapagliflozin helps manage heart failure by promoting diuresis, which helps alleviate fluid overload, and has been shown to reduce cardiovascular mortality.

What is Worsening Renal Function in heart failure patients?
Worsening renal function refers to a decline in kidney function in heart failure patients, often due to the use of diuretics and is associated with poor outcomes.

Why is the study of renal function important in heart failure?
The study of renal function is crucial because renal impairment is common in heart failure and can significantly affect prognosis and treatment options.

What are the implications of the study findings?
The study findings suggest that dapagliflozin can be safely incorporated into the treatment regimen for heart failure patients to reduce diuretic doses and potentially mitigate renal function decline.