Dapagliflozin Reduces AKI After Cardiac Surgery

A short perioperative course of dapagliflozin reduced acute kidney injury after elective cardiac surgery in a multicenter randomized clinical trial published in JAMA.

The double-blind placebo-controlled study (MERCURI-2) enrolled 784 adults at two academic medical centers and five nonacademic hospitals in the Netherlands. Participants were assigned to dapagliflozin 10mg orally or placebo once daily, beginning the day before surgery and continuing through the second postoperative day, for a total of four doses.

The primary outcome was acute kidney injury during the first 7 postoperative days, defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Among 778 participants who completed follow-up testing, acute kidney injury occurred in 28% of patients receiving dapagliflozin compared with 52% receiving placebo, for a relative risk of 0.54 (P<.001).

Atrial fibrillation and reoperation were the most frequent adverse events, with similar rates between treatment groups. The findings point to a potential short-course prevention strategy for a common complication after cardiac surgery.

Source: Oosterom-Eijmael MJP, Hulst AH, de Oliveira NPM, et al. Dapagliflozin and acute kidney injury following cardiac surgery: a randomized clinical trial. JAMA. Published online July 30, 2026. doi:10.1001/jama.2026.9268