BACKGROUND

• Empagliflozin’s effects on CKD progression are unclear
• The EMPA-KIDNEY trial aimed to evaluate empagliflozin in diverse CKD patients with varying kidney function

METHODS

• Patients with CKD were randomly assigned to:
  • Treatment Arm: Empagliflozin 10mg OD
  • Control Arm: Placebo
• Primary Outcome:
  • Composite of kidney disease progression or cardiovascular death
• Statistics:
  • Cox proportional hazards regression model analyzed time-to-event data
  • Adjustmens for baseline variables were made
  • Semi-parametric joint frailty model analyzed hospitalization outcomes
  • Shared paremeter models assessed annual eGFR change rates
• Follow Up:
  • Median duration of 2 years

RESULTS

• Primary Outcome:
  • 432 of 3304 patients (13.1%) on empagliflozin
  • 558 of 3305 (16.9%) on placebo
• Hazard Ratio:
  • Empagliflozin vs Placebo: 0.72 (p < 0.001)
• Hospitalisation Rates
  • Lower in Empagliflozin group (hazard ratio, 0.86; p = 0.003)
• Heart Failure:
  • No significant differences in heart failure hospitalisations
• Mortality Rates:
  • No significant differences in overall mortality rates
• Adverse Events
  • Serious adverse events were similar between both groups
  • CKD progression is often linked to decreased GFR and albuminuria

LIMITATIONS

• Lower than expected number of cardiovascular events reduced statistical power
• Some limitations in understanding empagliflozin’s effects on CKD
• Exclusion of patients with Polycystic Kidney Disease and Kidney Transplants

CONCLUSIONS