Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease
<p><strong>BACKGROUND:</strong> Chronic kidney disease (CKD) is associated with fluid excess which can be estimated by bioimpedance spectroscopy. We aimed to assess effects of sodium glucose co-transporter 2 inhibition on bioimpedance-derived “Fluid Overload” and adiposity in a CKD...
| Main Authors: | , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
American Society of Nephrology
2023
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| _version_ | 1811139764891418624 |
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| author | Mayne, K Haynes, R Keane, D Staplin, N Judge, P Preiss, D Emberson, J Dayanandan, R Lee, R Nolan, J Omata, A Landray, M Baigent, C Herrington, W |
| author2 | EMPA-KIDNEY Bioimpedance Substudy Group |
| author_facet | EMPA-KIDNEY Bioimpedance Substudy Group Mayne, K Haynes, R Keane, D Staplin, N Judge, P Preiss, D Emberson, J Dayanandan, R Lee, R Nolan, J Omata, A Landray, M Baigent, C Herrington, W |
| author_sort | Mayne, K |
| collection | OXFORD |
| description | <p><strong>BACKGROUND:</strong> Chronic kidney disease (CKD) is associated with fluid excess
which can be estimated by bioimpedance spectroscopy. We aimed to assess effects of sodium glucose co-transporter 2 inhibition on bioimpedance-derived “Fluid Overload” and adiposity in a CKD population.</p>
<p><strong>METHODS:</strong> EMPA-KIDNEY was a 6609-participant double-blind placebo-controlled
trial of empagliflozin 10 mg once daily in patients with CKD at risk of progression. In a 660-participant substudy, bioimpedance measurements were added to the main trial procedures at randomization, 2- and 18-month follow-up visits. The substudy’s primary outcome was the study-average difference in absolute “Fluid Overload” (an estimate of excess extracellular water) analyzed using a mixed-model repeated
measures approach.</p>
<p><strong>RESULTS:</strong> The 660 substudy participants were broadly representative of the 6609-
participant trial population. Substudy mean baseline absolute “Fluid Overload” was 0.4±1.7 L. Compared to placebo, the overall mean absolute “Fluid Overload” difference among those allocated empagliflozin was -0.24 L (95%CI -0.38, -0.11), with similar-sized differences at 2- and 18-months, and in pre-specified subgroups. Total body water differences comprised between-group differences in extracellular water of -0.49 L (95%CI -0.69, -0.30, including the -0.24 L “Fluid Overload” difference); and a -0.30 L (95%CI -0.57, -0.03) difference in intracellular water. There was no significant effect of empagliflozin on bioimpedance-derived adipose tissue mass (- 0.28 [95%CI -1.41, 0.85] kg). The between-group difference in weight was -0.7 kg
(95%CI -1.3, -0.1).</p>
<p><strong>CONCLUSIONS:</strong> In a broad range of patients with CKD, empagliflozin resulted in a
sustained reduction in a bioimpedance-derived estimate of fluid overload, with no statistically significant effect on fat mass.</p> |
| first_indexed | 2024-03-07T08:16:18Z |
| format | Journal article |
| id | oxford-uuid:e2f143c9-cb6a-47b4-90b8-6126e758fff1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:11:17Z |
| publishDate | 2023 |
| publisher | American Society of Nephrology |
| record_format | dspace |
| spelling | oxford-uuid:e2f143c9-cb6a-47b4-90b8-6126e758fff12024-06-19T11:20:46ZEffects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney diseaseJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e2f143c9-cb6a-47b4-90b8-6126e758fff1EnglishSymplectic ElementsAmerican Society of Nephrology2023Mayne, KHaynes, RKeane, DStaplin, NJudge, PPreiss, DEmberson, JDayanandan, RLee, RNolan, JOmata, ALandray, MBaigent, CHerrington, WEMPA-KIDNEY Bioimpedance Substudy Group<p><strong>BACKGROUND:</strong> Chronic kidney disease (CKD) is associated with fluid excess which can be estimated by bioimpedance spectroscopy. We aimed to assess effects of sodium glucose co-transporter 2 inhibition on bioimpedance-derived “Fluid Overload” and adiposity in a CKD population.</p> <p><strong>METHODS:</strong> EMPA-KIDNEY was a 6609-participant double-blind placebo-controlled trial of empagliflozin 10 mg once daily in patients with CKD at risk of progression. In a 660-participant substudy, bioimpedance measurements were added to the main trial procedures at randomization, 2- and 18-month follow-up visits. The substudy’s primary outcome was the study-average difference in absolute “Fluid Overload” (an estimate of excess extracellular water) analyzed using a mixed-model repeated measures approach.</p> <p><strong>RESULTS:</strong> The 660 substudy participants were broadly representative of the 6609- participant trial population. Substudy mean baseline absolute “Fluid Overload” was 0.4±1.7 L. Compared to placebo, the overall mean absolute “Fluid Overload” difference among those allocated empagliflozin was -0.24 L (95%CI -0.38, -0.11), with similar-sized differences at 2- and 18-months, and in pre-specified subgroups. Total body water differences comprised between-group differences in extracellular water of -0.49 L (95%CI -0.69, -0.30, including the -0.24 L “Fluid Overload” difference); and a -0.30 L (95%CI -0.57, -0.03) difference in intracellular water. There was no significant effect of empagliflozin on bioimpedance-derived adipose tissue mass (- 0.28 [95%CI -1.41, 0.85] kg). The between-group difference in weight was -0.7 kg (95%CI -1.3, -0.1).</p> <p><strong>CONCLUSIONS:</strong> In a broad range of patients with CKD, empagliflozin resulted in a sustained reduction in a bioimpedance-derived estimate of fluid overload, with no statistically significant effect on fat mass.</p> |
| spellingShingle | Mayne, K Haynes, R Keane, D Staplin, N Judge, P Preiss, D Emberson, J Dayanandan, R Lee, R Nolan, J Omata, A Landray, M Baigent, C Herrington, W Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease |
| title | Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease |
| title_full | Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease |
| title_fullStr | Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease |
| title_full_unstemmed | Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease |
| title_short | Effects of empagliflozin on fluid overload, weight and blood pressure in chronic kidney disease |
| title_sort | effects of empagliflozin on fluid overload weight and blood pressure in chronic kidney disease |
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