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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Clinical Diabetes

Efficacy and safety of sacubitril/valsartan combined with dapagliflozin in non-diabetic patients with advanced chronic kidney disease

Provisionally accepted
Huifang  WangHuifang WangXianyi  LiXianyi LiChunhui  JiangChunhui JiangXuemei  LiuXuemei Liu*
  • The Affiliated Hospital of Qingdao University, Qingdao, China

The final, formatted version of the article will be published soon.

Background: Data on the effects of sacubitril/valsartan combined with dapagliflozin in non-diabetic patients with advanced chronic kidney disease (CKD) are limited. In this study, we evaluated the efficacy and safety of sacubitril/valsartan plus dapagliflozin in non-diabetic patients with advanced CKD. Methods: A single-center, prospective cohort study was conducted in non-diabetic patients with advanced CKD who had not yet initiated renal replacement therapy. Group A included 65 patients who received combined sacubitril/valsartan and dapagliflozin therapy, while Group B consisted of 59 patients treated with sacubitril/valsartan alone. Estimated glomerular filtration rate (eGFR), proteinuria, blood pressure and serum potassium levels were assessed. Results: Baseline eGFR was 36.35(31.00, 46.47) and 40.01(30.12, 45.86) mL/min/1.73m² in the Group A and Group B, respectively. There was significant difference in eGFR between the two groups at month 6 [30.92(25.38, 35.38) vs. 25.42(21.58, 30.27)mL/min/1.73m², p < 0.001]. The difference in the change in eGFR between the two groups was statistically significant (p < 0.001). Compared with sacubitril/valsartan alone, the combination of sacubitril/valsartan and dapagliflozin provided an additional significant reduction in blood pressure, attenuated the decline in eGFR, reduced proteinuria, and lowered the risk of hyperkalemia (p < 0.05). Conclusion: In non-diabetic patients suffering from advanced CKD, treatment with sacubitril/valsartan combined with dapagliflozin effectively controlled blood pressure, reduced proteinuria, slowed the progression of renal dysfunction, and did not increase the risk of adverse events, indicating a favorable safety profile.

Keywords: Chronic Kidney Disease, sacubitril/valsartan, dapagliflozin, combinedtherapy, Glomerular Filtration Rate

Received: 07 Aug 2025; Accepted: 27 Nov 2025.

Copyright: © 2025 Wang, Li, Jiang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xuemei Liu

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