Perioperative Dapagliflozin Halves Postoperative AKI After Cardiac Surgery

This trial gives renal and surgical pharmacists the first randomized, double-blind evidence that a short perioperative course of an SGLT2 inhibitor lowers the incidence of acute kidney injury after elective cardiac surgery, though the benefit was driven largely by urine-output criteria and did not translate into hard clinical outcomes.

dapagliflozinSGLT2 inhibitorsacute kidney injurycardiac surgeryperioperativenephroprotectionKDIGOrandomized controlled trialMERCURI-2 Nephrology / Renal Pharmacy

Background Information

Dapagliflozin cuts acute kidney injury risk post-cardiac surgery.

Acute kidney injury (AKI) is a common complication after cardiac surgery and effective preventative treatments are needed. Dapagliflozin reduced the incidence of AKI compared to placebo (28% vs 52%, relative risk 0.54, P < .001). Initiating dapagliflozin before cardiac surgery may significantly lower the risk of AKI, but monitoring for adverse events like atrial fibrillation is crucial. Dapagliflozin markedly reduces AKI incidence in post-cardiac surgery patients.

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Authors: Oosterom-Eijmael MJP, Hulst AH, de Oliveira NPM, Niesten ED, Wietsma NE, Gerritse BM, Scohy TV, Rettig TCD, Snellen FTF, Voogd MF, Godfried MB, de Boer RN, Wink J, van der Werff LMM, Cobbaert CM, Ruhaak LR, Eberl S, Preckel B, Hollmann MW, Schenk J, Hermanides J, van Raalte DH, MERCURI-2 Study Group

Citation: Oosterom-Eijmael MJP, Hulst AH, de Oliveira NPM, et al. Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial. JAMA. 2026. doi:10.1001/jama.2026.9268

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

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Secondary Outcomes & Safety Profile

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