Nephrotic-range proteinuria in type 2 diabetes: Effects of empagliflozin on kidney disease progression and clinical outcomes
Piero Ruggenenti, Bettina J. Kraus, Silvio E. Inzucchi, Bernard Zinman, Stefan Hantel, Michaela Mattheus, Maximilian von Eynatten, Giuseppe Remuzzi, Audrey Koitka‐Weber, Christoph Wanner
Abstract
BACKGROUND: analysis of data from the EMPA-REG OUTCOME trial (NCT01131676). METHODS: Cox proportional hazards models were used to investigate the risk of cardiovascular and kidney outcomes in participants with and without NRP, defined by urine albumin-to-creatinine ratio (UACR) ≥2200 mg/g at baseline. Annual loss of eGFR during chronic treatment (eGFR slopes) and hypothetical time to projected end-stage kidney disease (ESKD), conditioning upon linearity of eGFR change over time if a patient did not decease before projected ESKD, were calculated using a random-intercept random-coefficient model. Safety was described based on investigator-reported adverse events. FINDINGS: 0·005). Empagliflozin was estimated to double the median hypothetical time to projected ESKD in participants with NRP. The overall safety profile of empagliflozin was comparable between participants with and without NRP at baseline. INTERPRETATION: Our data suggests that empagliflozin might slow kidney function loss and delay the estimated onset of projected ESKD in patients with type 2 diabetes and cardiovascular disease complicated by NRP.