RecentRCT

Perioperative dapagliflozin

Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial

JAMA, 2026 · Double-blind randomized trial

Population: 784 adults undergoing elective cardiac surgery
Intervention: Four dapagliflozin doses starting the day before surgery
Comparator: Placebo
Primary outcome: AKI within seven postoperative days
Result: 28% versus 52%; RR 0.54 (95% CI 0.45–0.65), P<.001.

What the trial found

28% versus 52%; RR 0.54 (95% CI 0.45–0.65), P<.001.

Clinical interpretation

The AKI result is promising but conflicts with routine perioperative SGLT2-interruption guidance. Do not start or continue it around surgery from this summary alone; assess full safety data, ketoacidosis risk and current labeling with specialists.

Limitations

Apply only to the trial-defined population and outcomes; full protocol and subgroup appraisal remains in the audit ledger.

Moderate certainty

Clinical Context & Relevant Topics (1)

Disease Reference

Acute Kidney Injury in Critical Care

Sepsis-AKI microcirculatory decoupling, KDIGO staging, Furosemide Stress Test (FST), urine microscopy, and the AEIOU dialysis threshold framework.

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