Empagliflozin and Incidence of Events Consistent With Acute Kidney Injury: Pooled Safety Analysis in More Than 15,000 Individuals
Diabetes Obes Metab 2022;24:1390-3 doi: 10.1111/dom.14694
In this pooled analysis of patients from the global empagliflozin trial programme, the risk of acute kidney injury (AKI) and acute kidney disease (AKD) with empagliflozin was comparable with placebo. This comprehensive analysis indicates that empagliflozin is not associated with an increased risk of acute kidney failure compared with placebo treatment.
Chronic kidney disease (CKD) develop in about 40% of people with T2D. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are key treatment option for T2D to reduce the risk of
cardiovascular and renal outcomes, and have also shown beneficial effects in heart failure and CKD independent of T2D. But SGLT2i also acutely decrease eGFR, and there is a concern the class may predispose patients to AKI. This pooled analysis looked at safety datasets from 20 trials across the empagliflozin clinical trial programme.
The incidence of AKI and AKD events was numerically lower in the empagliflozin versus placebo group, and remained lower with empagliflozin across all baseline categories.
These results are supported by observational studies in propensity score-matched cohorts and meta-analyses, which have previously reported that SGLT2i reduce the risk of AKI.