Title:Empagliflozin and the Diabetic Kidney: Pathophysiological Concepts and Future Challenges
Volume: 21
Issue: 9
Author(s): Georgios S. Papaetis*
Affiliation:
- Internal Medicine and Diabetes Clinic, Eleftherios Venizelos Avenue 62, Paphos, Cyprus; 2CDA College, 73 Democratias Avenue, Paphos,Cyprus
Keywords:
Type 2 diabetes, empagliflozin, SGLT2 inhibitors, glucosuria, chronic kidney disease, EMPA-REG OUTCOME
trial.
Abstract: Chronic kidney disease is a serious co-morbidity of patients with diabetes, which amplifies
the global burden of this disease, affects the quality of their life, and significantly increases both morbidity
and mortality. Therefore, there is a high unmet clinical need to develop therapeutic strategies in
order to prevent, delay, or even reverse its evolution. EMPA-REG OUTCOME trial has fundamentally
changed the therapeutic landscape of patients with type 2 diabetes and signified a new era in which
treatment approaches should be tailored based on end-organ protection and patient comorbidities rather
than focusing only on their antihyperglycemic effects. This paper discusses the seminal EMPA-REG
OUTCOME trial, focusing on its renal outcomes, and explores extensively the possible pathophysiological
mechanisms governing the nephroprotective activity of empagliflozin both in in vitro and in
vivo (animal models and humans) studies during a diabetic state. It also discusses the safety of empagliflozin
therapy and its future role in order to ameliorate the global burden of CKD both in patients
with and without diabetes.
