Impact of Empagliflozin on Glomerular Hyperfiltration and Albuminuria in Youth with Type 2 Diabetes: Post Hoc Analysis of DINAMO.
Abstract
KEY POINTS: We investigated the effects of empagliflozin on hyperfiltration and albuminuria in youth with type 2 diabetes. Hyperfiltration and albuminuria were significantly attenuated compared with placebo in adolescents aged 10–17 years with type 2 diabetes on empagliflozin. Additional studies are required to evaluate the effect of sodium-glucose cotransporter-2 inhibition on diabetic kidney disease risk in youth.
BACKGROUND: Hyperfiltration, common in youth with type 2 diabetes (T2D), may increase the risk of early diabetic kidney disease. The Diabetes Study of Linagliptin and Empagliflozin in Children and Adolescents and Diabetes Study of Linagliptin and Empagliflozin in Children and Adolescents MONO trials showed that compared with placebo, empagliflozin improved glycemic control in youth with T2D. This post hoc analysis evaluated empagliflozin versus placebo on selected parameters in participants from both trials according to their baseline (BL) hyperfiltration/normofiltration status.
METHODS: We calculated eGFR using the Zappitelli equation (combined serum creatinine and cystatin C), with hyperfiltration defined as 2 SDs above average for healthy youth per National Health and Nutrition Examination Survey (>126.8 ml/min per 1.73 m2). After randomization, 116 participants received empagliflozin (10 mg or 25 mg) or placebo. We compared responses to therapy for eGFR and urine albumin-creatinine ratio (UACR) at week 26 by BL hyperfiltration and normofiltration (≤126.8…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 116 participants or records.
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