Dapagliflozin attenuates progression from prefrailty to frailty in patients with hypertension and chronic kidney disease.

In hypertensive older adults with chronic kidney disease, dapagliflozin use is linked to lower odds of progressing from prefrailty to frailty at 1 year (OR = 0.130).

• Why it matters: Frailty progression in older people with CKD and hypertension is a high-risk gap, and the study tests whether renal injury and physical decline relate to that progression.
• What they did: DAPA-FORTRESS enrolled 135 prefrail patients aged over 65 with hypertension and CKD, matched to 105, then used correlation/regression for albuminuria, eGFR, and physical performance, and multivariable logistic regression for frailty progression.
• The result: Higher albuminuria is inversely associated with gait speed (r2 = 0.48, P < 0.0001), and gait speed is positively associated with eGFR (r2 = 0.18; P < 0.0001); dapagliflozin independently predicts reduced frailty progression at 1 year (CI 0.045-0.381; P < 0.001).

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