The following is a summary of “Daprodustat and Heart Failure in CKD,” published in the February 2024 issue of Nephrology by Cunningham et al.

Researchers conducted a retrospective study to investigate whether daprodustat, an orally administered hypoxia inducible factor prolyl hydroxylase inhibitor, influences the incidence of heart failure (HF) hospitalization in patients with chronic kidney disease (CKD) compared to conventional injectable erythropoietin-stimulating agents (ESA).

They examined the ASCEND-D trial (n = 2,964) and the ASCEND-ND trial (n=3,872) to contrast daprodustat with conventional ESA in patients experiencing anemia of CKD, with or without the necessity for dialysis, respectively. Risk factors for HF hospitalization were pinpointed, and the impact of daprodustat on HF hospitalizations compared to conventional ESA was evaluated.

The results showed that a history of HF, diabetes, and higher systolic blood pressure independently correlated with HF hospitalization in both trials, regardless of treatment assignment. The daprodustat arm exhibited a greater number of first HF hospitalizations in patients not receiving dialysis (HR 1.22 [0.95-1.56], P=0.12) and in patients receiving dialysis (HR 1.10 [0.84-1.45], P=0.47), although these differences were not statistically significant. In patients with and without a history of HF, HRs were 1.37 (0.89-2.11) vs 1.08 (0.79-1.46) (p-interaction=0.36) in ASCEND-ND and 1.52 (0.97-2.38) vs 0.93 (0.66-1.30) (p-interaction=0.09) in ASCEND-D. Post hoc analyses revealed that daprodustat increased total (first and recurrent) HF hospitalizations in participants not receiving dialysis (RR 1.46 [1.11-1.92], P=0.007) but not in participants receiving dialysis (RR 1.01 [0.74-1.39], P=0.93). Daprodustat did not significantly impact the risk of a composite outcome of the first HF hospitalization or death.

Investigators concluded that daprodustat increased first HF hospitalizations compared to conventional ESA; the difference wasn’t statistically significant, with the effect most pronounced in non-dialysis and prior HF patients.

Source: journals.lww.com/jasn/abstract/9900/daprodustat_and_heart_failure_in_ckd.263.aspx