The following is a summary of “Effects of Empagliflozin on Fluid Overload, Weight and Blood Pressure in Chronic Kidney Disease,” published in the December 2023 issue of Nephrology by Mayne et al.
Researchers conducted a retrospective study investigating how SGLT2 inhibitors impact fluid overload and adiposity measured by bioimpedance in CKD patients.
They conducted EMPA-KIDNEY, a double-blind placebo-controlled trial of empagliflozin 10 mg once daily in patients with CKD at risk of progression. Bioimpedance measurements were integrated into the main trial procedures at randomization, 2 months, and 18 months follow-up.
The substudy focused on the average difference in absolute “Fluid Overload” (an estimate of excess extracellular water) using a mixed-model repeated measures approach.
The results showed 660 substudy participants, and the baseline absolute “Fluid Overload” was 0.4±1.7 L, representing the 6,609-participant trial population. In comparison to placebo, those allocated empagliflozin exhibited an overall mean absolute “Fluid Overload” difference of -0.24 L (95%CI -0.38, -0.11), with consistent differences at 2- and 18-months and across pre-specified subgroups. Between-group differences in total body water included a -0.49 L (95% CI -0.69, -0.30) reduction in extracellular water, incorporating the -0.24 L “Fluid Overload” difference, and a -0.30 L (95%CI -0.57, -0.03) difference in intracellular water. Empagliflozin did not significantly affect bioimpedance-derived adipose tissue mass (-0.28 [95% CI -1.41, 0.85] kg), and the between-group difference in weight was -0.7 kg (95%CI -1.3, -0.1).
They concluded that empagliflozin sustainedly reduced fluid overload estimates in diverse CKD patients without affecting fat mass.
Source: journals.lww.com/jasn/abstract/9900/effects_of_empagliflozin_on_fluid_overload,_weight.223.aspx
