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Nephrology
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Empagliflozin reduces risk of progression in at-risk patients with chronic kidney disease

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Treatment with empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular in patients with chronic kidney disease who were at risk for disease progression compared with placebo, according to trial results published in The New England Journal of Medicine.

EMPA-KIDNEY was the largest and broadest dedicated SGLT2 inhibitor trial in chronic kidney disease.

The study randomly assigned 6609 patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of ≥20 but <45 ml per minute per 1.73 m2 of body-surface area, or who had an eGFR of ≥45 but < 90 ml per minute per 1.73 m2 with a urinary albumin-to-creatinine ratio of at least 200 to receive empagliflozin (10 mg once daily) or matching placebo.

The progression of kidney disease or death from cardiovascular causes over a median 2 years of follow-up occurred in 13.1% (432 out of 3304 patients) in the empagliflozin group and 16.9% (558 out of 3305 patients) in the placebo group. These results were found to be consistent in patients with or without diabetes as well as across subgroups defined by eGFR ranges.

There was a significant reduction in all-cause hospitalizations in patients treated with empagliflozin (14%) compared with those treated with placebo.

Serious adverse event rates were similar between the groups.

“The design of the EMPA-KIDNEY trial included a wider range of patients than ever before,” said Professor Richard Haynes, co-principal investigator in a press release. “Previous SGLT2 inhibitor trials focused on certain groups of people living with CKD, such as those with diabetes or high levels of protein in their urine. Today’s positive trial results across a broad CKD population reflect an opportunity to improve the treatment of this disease and prevent people from needing dialysis.”

Reference
The EMPA-KIDNEY Collaborative Group. Empagliflozin in Patients with Chronic Kidney Disease. NEJM. 2022;DOI: 10.1056/NEJMoa2204233

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