Acute and Chronic Effects of SGLT2 Inhibitor Empagliflozin on Renal Oxygenation and Blood Pressure Control in Nondiabetic Normotensive Subjects: A Randomized, Placebo-Controlled Trial.
Détails
Télécharger: 32567439_BIB_D74B267E8EEE.pdf (621.90 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_D74B267E8EEE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Acute and Chronic Effects of SGLT2 Inhibitor Empagliflozin on Renal Oxygenation and Blood Pressure Control in Nondiabetic Normotensive Subjects: A Randomized, Placebo-Controlled Trial.
Périodique
Journal of the American Heart Association
ISSN
2047-9980 (Electronic)
ISSN-L
2047-9980
Statut éditorial
Publié
Date de publication
07/07/2020
Peer-reviewed
Oui
Volume
9
Numéro
13
Pages
e016173
Langue
anglais
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
Background The sodium/glucose cotransporter 2 inhibitor empagliflozin has cardiorenal protective properties through mechanisms beyond glucose control. In this study we assessed whether empagliflozin modifies renal oxygenation as a possible mechanism of renal protection, and determined the metabolic, renal, and hemodynamic effects of empagliflozin in nondiabetic subjects. Methods and Results In this double-blind, randomized, placebo-controlled study, 45 healthy volunteers underwent blood and urine sampling, renal ultrasound, and blood-oxygenation-level-dependent magnetic resonance imaging before and 180 minutes after administration of 10 mg empagliflozin (n=30) or placebo (n=15). These examinations were repeated after 1 month of daily intake. Cortical and medullary renal oxygenation were not affected by the acute or chronic administration of empagliflozin, as determined by 148 renal blood-oxygenation-level-dependent magnetic resonance imaging examinations. Empagliflozin increased glucosuria (24-hour glucosuria at 1 month: +50.1±16.3 g). The acute decrease in proximal sodium reabsorption, as determined by endogenous fractional excretion of lithium (-34.6% versus placebo), was compensated at 1 month by a rise in plasma renin activity (+28.6%) and aldosterone (+55.7%). The 24-hour systolic and diastolic ambulatory blood pressures decreased significantly after 1 month of empagliflozin administration (-5.1 and -2.0 mm Hg, respectively). Serum uric acid levels decreased (-28.4%), hemoglobin increased (+1.7%), and erythropoietin remained the same. Conclusions Empagliflozin has a rapid and significant effect on tubular function, with sustained glucosuria and transient natriuresis in nondiabetic normotensive subjects. These effects favor blood pressure reduction. No acute or sustained changes were found in renal cortical or medullary tissue oxygenation. It remains to be determined whether this is the case in nondiabetic or diabetic patients with congestive heart failure or kidney disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03093103.
Mots-clé
Adolescent, Adult, Benzhydryl Compounds/therapeutic use, Biomarkers/blood, Blood Pressure/drug effects, Double-Blind Method, Female, Glucosides/therapeutic use, Healthy Volunteers, Humans, Kidney/blood supply, Male, Middle Aged, Natriuresis/drug effects, Oxygen/blood, Oxygen Consumption/drug effects, Renal Circulation/drug effects, Sodium-Glucose Transporter 2 Inhibitors/therapeutic use, Switzerland, Time Factors, Young Adult, BOLD‐MRI, SGLT2, blood pressure, empagliflozin, renal oxygenation
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/07/2020 19:43
Dernière modification de la notice
14/03/2023 7:49