In older prefrail hypertensive patients with CKD, greater renal injury was associated with worse physical performance, while dapagliflozin use was independently associated with lower odds of progressing to frailty at 1 year, suggesting a potential protective role of SGLT2 inhibition against functional decline.
Gait speed was inversely associated with albuminuria in older prefrail hypertensive patients with CKD.
Gait speed was positively and linearly associated with eGFR.
Patients with eGFR <60 mL/min/1.73 m2 had significantly worse physical performance than those with higher eGFR.
Dapagliflozin use was independently associated with lower odds of progressing from prefrailty to frailty at 1 year.
The study enrolled 135 prefrail hypertensive patients with CKD aged >65 years and used matching to balance the dapagliflozin and comparison groups.
The authors conclude that greater renal injury is associated with worse physical performance and that SGLT2 inhibition may mitigate functional decline in this high-risk population.
This study followed 135 older adults (over 65) who had high blood pressure, chronic kidney disease, and early signs of frailty (prefrailty) for one year. After matching patients to make the groups comparable, 105 were analyzed, 52 of whom took dapagliflozin, a drug in the SGLT2 inhibitor class. The researchers looked at how kidney damage relates to physical performance and whether dapagliflozin was linked to progression to full frailty. They found that worse kidney health went along with worse physical function. Higher levels of protein in the urine (albuminuria) were strongly linked to slower walking speed, and lower kidney filtration (eGFR) was also linked to slower walking. Patients with eGFR below 60 performed worse physically than those with higher eGFR. Patients taking dapagliflozin had much lower odds of progressing to frailty over the year (odds ratio 0.130). This research suggests that kidney damage and physical decline are closely connected in older people with hypertension and CKD, and that SGLT2 inhibitors might help slow functional decline. Because the study compared patients who did or did not take the drug rather than randomly assigning treatment, it shows an association and cannot prove that the drug caused the benefit. Larger randomized trials would be needed to confirm these results.
Mone P, Viggiano D, Pansini A, Soldovieri M, Sabatelli G, Visco V, et al.. (2026). Dapagliflozin attenuates progression from prefrailty to frailty in patients with hypertension and chronic kidney disease.. The Journal of clinical investigation. https://doi.org/10.1172/JCI205416