- Question
- Does empagliflozin reduce kidney disease progression and cardiovascular death in a broad range of patients with chronic kidney disease at risk of progression, with or without diabetes?
- Design
- International, multicentre, randomized, double-blind, placebo-controlled phase 3 trial with 6609 randomized patients and a median follow-up of 2.0 years.
- Population
- Patients with chronic kidney disease with an eGFR of at least 20 and less than 45 ml/min/1.73 m2, or an eGFR of at least 45 and less than 90 ml/min/1.73 m2 with a urinary albumin-to-creatinine ratio of at least 200; with or without diabetes.
- Intervention
- Empagliflozin 10 mg orally once daily.
- Control
- Matching placebo once daily.
- Primary outcome
- Composite of kidney disease progression (end-stage kidney disease, sustained eGFR decline to <10 ml/min/1.73 m2, sustained eGFR decline of ≥40% from baseline, or renal death) or cardiovascular death.
- Results
- The primary outcome occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and 558 of 3305 (16.9%) in the placebo group (HR 0.72; 95% CI 0.64 to 0.82; P<0.001), with consistent results regardless of diabetes status and across eGFR ranges. Hospitalization from any cause was lower with empagliflozin (HR 0.86; 95% CI 0.78 to 0.95; P = 0.003).
- Safety
- Rates of serious adverse events were similar in the two groups.
- Conclusion
- In a wide range of patients with chronic kidney disease at risk of progression, empagliflozin lowered the risk of kidney disease progression or cardiovascular death compared with placebo.
- Why it matters
- It extended the benefit of SGLT2 inhibitors to a broader kidney disease population, including patients without diabetes and across different levels of kidney function and albuminuria.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026