Empagliflozin Slows Progression of Chronic Kidney Disease and Reduces Risk of Kidney Failure

Chronic Kidney Disease

Chronic Kidney Disease (CKD) is a progressive disease that affects millions of people worldwide. The disease causes severe symptoms such as low estimated glomerular filtration rate (eGFR) and high levels of albuminuria, which can lead to kidney failure. To avoid dialysis and kidney transplant, which may lead to cardiovascular morbidity or mortality, slowing CKD progression is a favorable outcome. A recent study published in the New England Journal of Medicine has shown that the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagliflozin ( the generic name of Jardiance) can help reduce the progression of CKD in patients at risk for disease progression. Empagliflozin is the generic name of

The EMPA-KIDNEY Study

The EMPA-KIDNEY study was an international, randomized, parallel-group, double-blind, placebo-controlled, clinical trial that evaluated the safety and efficacy of empagliflozin for progressive kidney disease and cardiovascular disease (CVD) between February 2019 and April 2021. The study included 6609 randomized patients broadly representative of the CKD population at risk for disease progression, who were assigned either once daily empagliflozin at 10 mg or placebo. The study’s primary outcome was CKD progression (end-stage kidney disease), sustained low eGFR below 10 ml per minute per 1.73 m2 of body-surface area, an eGFR lower by 40% or more from baseline, or death from renal or cardiovascular causes.

Results

The results of the study showed that empagliflozin decreased the likelihood of disease progression or death from CVD-related causes by 28% compared to the placebo.

Risk of any-cause hospitalization was also 14% lower in the empagliflozin arm compared to the placebo arm. Additionally, death from renal or cardiovascular causes occurred less in the empagliflozin arm at 13.1%. Deaths occurred at a rate of 16.9% in the placebo group. Empagliflozin had favorable results on GFR in all subgroups compared to placebo, including patients with diabetes and patients with a low urinary albumin-to-creatinine ratio.

SGLT2 inhibitors have been found to reduce the risk of kidney failure in patients with increased albuminuria and diabetic kidney disease. However, the effects of the SGLT2 inhibitor empagliflozin were not fully understood until now. Past and present studies found that SGLT2 inhibitors can lower the risk of death from cardiovascular causes by 14% and decrease risk of hospitalization related to cardiovascular issues by 23%.

Limitations

The trial does contain some limitations, such as lower-than-expected cardiovascular events. Adverse events associated with treatment included ketoacidosis, lower limb amputation, serious urinary tract infection, hyperkalemia, acute kidney injury, serious dehydration, and liver injury, but these are no worse in the placebo arm. However, the study authors note that

"treatment with empagliflozin was effective…with respect to the primary outcome [and] was generally consistent across prespecified key subgroups and other prespecified subgroups."

Conclusion

The results of the EMPA-KIDNEY study suggest that empagliflozin may be an effective treatment option for reducing the progression of CKD in patients at risk for disease progression. The study authors suggest that empagliflozin "may be considered as an option to slow the progression of kidney disease and reduce the risk of death from cardiovascular causes in patients with CKD." As with all medications, it is important to consult with a healthcare professional before starting any treatment.

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Related Articles

What is Chronic Kidney Disease?

What Do Your Kidneys Do?

Creatinine and eGFR; What Are They and Why Are They Important?

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References

Study: Empagliflozin Can Slow Progression of Chronic Kidney Disease to Kidney Failure

Empagliflozin in Patients with Chronic Kidney Disease

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‍About the Author

Rich Foreman brings over 30 years of technology leadership to his role of CEO and Co-Founder of KidneySoft.  As founding CTO, Rich led the team that developed the CordicoShield / CordicoFire Wellness App. Cordico was honored with the Sacramento Innovation Award in 2021. After achieving a 7 digit ARR, Cordico was acquired by Lexipol in 2020. Rich has a BS in Industrial Engineering from the University of Washington, an MPA from Troy State University and was an officer in the U.S. Navy. Rich co-authored his book, "Tap into the Mobile Economy." Rich's blog was listed in Top 20 Marketing Mobile Blogs of 2014. He has been featured on KCRA3, NEWS10, 1170 Tech AM PowerDrive, Business Radio Money 105.5, SiliconIndia, the Sacramento Business Journal, and the Sacramento Bee. Rich is also the Founding Director of the Sacramento Chapter of Startup Grind and served a term as Utility Commissioner for the City of Folsom. Rich is a regular contributor to TechWire.net and StartupSac. Rich was the Co-founder of Apptology which was named Small Business of the Year in 2014 by the Sacramento Asian Pacific Chamber. He was also the Founding Chief Technology Officer at Cordico. Cordico was acquired by Lexipol in 2020.  Rich also served 4 years as a Naval Officer in the Civil Engineer Corps.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.

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