NICE recommends dapagliflozin for chronic kidney disease

NICE recommends dapagliflozin (Forxiga) as an add-on to standard care in adults with chronic kidney disease (CKD), with or without diabetes.

Blue and orange 3D computerised illustration of kidneys.
Dapagliflozin is given at a dose of 10mg daily in patients with chronic kidney disease. | GETTY IMAGES

Dapagliflozin is recommended by NICE as a treatment option for CKD in adults.

Dapagliflozin is recommended only if: 

  • it is an add-on to optimised standard care, including the highest tolerated licensed dose of ACE inhibitors or angiotensin II antagonists, unless these are contraindicated, and 
  • people have an eGFR of 25–75ml/min/1.732 at the start of treatment, and have type 2 diabetes or have a urine albumin-to-creatinine ratio (uACR) of >22.6mg/mmol. 

The recommendation is based on the results of the DAPA-CKD trial, published in 2020, which showed that dapagliflozin was a significant benefit in reducing CKD progression and mortality from renal or cardiovascular causes. 

Slow disease progression

Professor James Burton, Professor of Renal Medicine and Honorary Consultant Nephrologist, University of Leicester, said: 'I am thrilled by this decision from NICE, as this expanded recommendation is going to have a genuine impact on the way that kidney doctors and GPs can treat their patients. For the first time in almost two decades, eligible people living with chronic kidney disease will have access to a new treatment option that has been shown to slow kidney decline and potentially delay transplant or dialysis. Given the impact those treatments can have on the quality of life of patients and those around them, this represents a significant milestone for many people living with kidney disease.'

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