Risk Factors for the Initial Decline in Estimated Glomerular Filtration Rate (eGFR) Following Empagliflozin Therapy in Patients with Heart Failure reduced Ejection Fraction (HFrEF)
Abstract
Heart failure is a long-term condition where the heart doesn’t pump blood as well as it should. It affects millions of people around the world and can lead to serious health problems, including damage to the kidneys. Heart failure can be measured by an Ejection fraction (EF), which shows how much blood the left ventricle (chamber responsible for pumping blood) pumps out with each contraction. EF is measured as a percentage. Heart failure with reduced ejection fraction (HFrEF) occurs when the heart muscle does not contract effectively and less oxygen-rich blood is pumped out to the body. A newer type of medication called sodium-glucose cotransporter 2 (SGLT2) inhibitors—such as empagliflozin—has been shown to help people with HFrEF live longer and stay healthier. Empagliflozin works by helping the kidneys get rid of extra salt and water through urine. This can lower blood pressure and reduce the strain on the heart, which improves how well the heart functions—especially in people with heart failure. However, doctors have noticed that soon after starting this medication, some patients experience a small drop in kidney function. This drop, called the “initial dip”, usually happens in the first one to two weeks of treatment and is measured by a test called estimated Glomerular Filtration Rate (eGFR), which checks how well the kidneys are working by evaluating how well they are filtering waste in the body. We recently found that this initial dip is more common in older adults and…
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