EFFECT OF ADDING DAPAGLIFLOZIN TO ALLOGRAFT DYSFUNCTION OF RENAL TRANSPLANTED PATIENTS.

Inclusion criteria

• Renal Transplanted patients with one to 5 years after transplantation, being followed at the out-patient clinics of the HCFMUSP and HRim;
• ≥18years of age;
• 45 ≥ eGFR ≥ 25 mL/min/1.73m2 or 45<eGFR<60 ml/min/1.73m2 with a loss of eGFR of ≥10% in the last year.

Exclusion criteria

• Type 1 diabetes;
• New York Heart Association Class IV congestive heart failure;
• Myocardial infarction, unstable angina, stroke or transient ischaemic attack within 8 weeks prior to enrolment;
• Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting) or valvular repair/replacement within 8weeks prior to enrolment;
• Any condition outside the renal and cardiovascular study area with a life expectancy of < 1 year based on investigator's clinical judgement;
• Hepatic impairment [aspartate transaminase or alanine transaminase >3 times the upper limit of normal (ULN) or total bilirubin >2 times the ULN at the time of enrolment;
• Acute or chronic antibody mediated rejection;
• Albuminuria due to other causes (mTOR inhibitors, Polyoma nephropathy, lymphoproliferative disorder etc…)
• Patients with a previous medical history of recurrent urinary tract infections or severe genital infection;
• Renal biopsies showing acute or chronic anti-body mediated rejection, transplant glomerulopathy, BKV nephropathy.
• Patients under any other IS regimen besides Tacrolimus/MPA/Steroids
• Pregnant patients as well as those breastfeeding.