Empagliflozin in Patients with Chronic Kidney Disease

The EMPA KIDNEY trial evaluated the efficacy and safety of empagliflozin in 6609 patients with chronic kidney disease (CKD) at risk for progression, including those with and without diabetes. Participants were randomized to receive empagliflozin (10 mg daily) or placebo. Over a median follow-up of 2 years, empagliflozin reduced the primary composite outcome of kidney disease progression (end-stage kidney disease, sustained eGFR decline ≥40%, or renal death) or cardiovascular death by 28% (13.1% vs. 16.9%; HR 0.72, 95% CI 0.64–0.82, P<0.001). Benefits were consistent across subgroups, including patients without diabetes and those with low albuminuria. Empagliflozin also reduced hospitalization rates (HR 0.86, P=0.003) and slowed eGFR decline (1.37 ml/min/1.73 m²/year difference). Safety profiles were similar between groups, with rare cases of ketoacidosis. These findings support empagliflozin as a therapeutic option for a broad CKD population.

The EMPA KIDNEY trial evaluated the efficacy and safety of empagliflozin in 6609 patients with chronic kidney disease (CKD) at risk for progression, including those with and without diabetes. Participants were randomized to receive empagliflozin (10 mg daily) or placebo. Over a median follow-up of 2 years, empagliflozin reduced the primary composite outcome of kidney disease progression (end-stage kidney disease, sustained eGFR decline ≥40%, or renal death) or cardiovascular death by 28% (13.1% vs. 16.9%; HR 0.72, 95% CI 0.64–0.82, P<0.001). Benefits were consistent across subgroups, including patients without diabetes and those with low albuminuria. Empagliflozin also reduced hospitalization rates (HR 0.86, P=0.003) and slowed eGFR decline (1.37 ml/min/1.73 m²/year difference). Safety profiles were similar between groups, with rare cases of ketoacidosis. These findings support empagliflozin as a therapeutic option for a broad CKD population.