Effect of Empagliflozin on Progression of Diabetic Kidney Disease in Type 2 Diabetes Patients at Sunpasitthiprasong Hospital

Abstract

Background: The primary causes of chronic kidney diseases requiring dialysis are hypertension and diabetes. In diabetes, progressive albuminuria leads to a decline in glomerular filtration rate and end-stage renal disease. Sodium-glucose co-transporter 2 Inhibitors (SGLT2i) are a new class of antidiabetic agents with renoprotective action. However, most studies on the effects of SGLT2i on renal function in diabetic kidney disease (DKD) have been conducted in Europe and the United States.
Objective: This study aims to compare the effect of Empagliflozin on albuminuria and the estimated glomerular filtration rate (eGFR) in Thai diabetic kidney disease patients.
Methods: This is a retrospective study of type 2 diabetes patients with a urine albumin creatinine ratio (UACR) more than 30 mg/g creatinine between 1^st January 2018 to 31^st August 2023. Patients were divided into 2 groups, using a 1:2 ratio, one group was treated with Empagliflozin and the other group received other diabetes drugs. Treatment results were assessed by testing the UACR and eGFR before and after two years of taking the drug.
Results: A total of 246 diabetic nephropathy patients were included in the analysis, with 82 cases in Empagliflozin treatment and 164 cases in the other drug group. After two years, the UACR was significantly lower in the Empagliflozin treatment group compared to the other drug group (475.4 and 841.4 mg/g creatinine, p <0.001). The eGFR was also significantly higher in the Empagliflozin treatment group than in the other drug group (87.4 and 78.9 ml/min/1.73 m², p 0.009). Additionally, Empagliflozin was able to reduce hemoglobin A1C and systolic blood pressure.
Conclusion: Empagliflozin treatment was associated with reduced albuminuria and a slower decline in eGFR among patients with DKD in the Thai population.