2) This work was presented by Will Herrington @willkidney, @The_MRC @Kidney_Research UK funded AssocProf @Oxford_NDPH and representing the contributions of 241 participating sites from 8 countries ๐๐. EMPA-KIDNEY was funded and sponsored by Boehringer Ingelheim. pic.twitter.com/ucsOdaNi2u
— @CKD_ce (@ckd_ce) November 9, 2022
4) #KIDNEYWEEK2022 was held in Orlando Nov 3-6 and was attended by some 10,000 #kidney professionals from across the globe. Scientific abstracts from the program can be accessed at ๐ https://t.co/jBP8RB8Zys. As has been the case for a couple years now, #SGLT2i was a ๐ถ๏ธtopic.
— @CKD_ce (@ckd_ce) November 9, 2022
6a) Which of the following mechanistic effects have been put forward to explain renoprotective effects of #SGLT2i?
— @CKD_ce (@ckd_ce) November 9, 2022
a. decreased workload of proximal tubular cells
b. โฌ๏ธ in intraglomerular pressure
c. body weight loss
d. a & c
7) We have known for a while now that it was stopped early for efficacy, but we needed details. @willkidney provided those details on 4 November in Orlando. A manuscript was simultaneously published in @NEJM at ๐https://t.co/rUdAYSLYJ5. pic.twitter.com/uyXYbdR9JB
— @CKD_ce (@ckd_ce) November 9, 2022
9a) To be enrolled, background tx w/ #RASi as appropriate was required. Intervention then was 1:1 randomization to #empagliflozin 10mg QD or placebo. Sample size: event-driven towards min 1070 primary #outcomes, defined as composite of #CV death or #CKD progression
— @CKD_ce (@ckd_ce) November 9, 2022
10)
— @CKD_ce (@ckd_ce) November 9, 2022
๐6609 patients were enrolled and were well-matched. Mean age ~ 64 years, 1/3 โ๏ธ, 54% no #DM at baseline. Mean #eGFR=37, median urinary #ACR ~ 330mg/g.
๐"Broad range" enrollment target met, as 31% of #CKD attributable to #DKD and 25% to #glomerular disease. pic.twitter.com/9P7xYXc9eH
12a) Let's break down that #composite primary outcome into its components.
— @CKD_ce (@ckd_ce) November 9, 2022
๐29% RRR for #CKD progression–this was the majority of the outcomes.
๐CV death: numerically lower in the #empagliflozin group but NS pic.twitter.com/MIvodLWVTH
13a) There was of course great interest in subgroup analysis, especially about diabetes. (Hey, remember those quaint days of yore when we thought #SGLT2i were "just" #T2D drugs?) With respect to #CKD, non-diabetics have been underrepresented in previous trials.
— @CKD_ce (@ckd_ce) November 9, 2022
14) Looking at #SGLT2i impact by baseline renal function, @willkidney et al showed that there were 564 first primary outcomes in pts w/ #eGFR < 30, again providing robust new evidence in this less studied group.
— @CKD_ce (@ckd_ce) November 9, 2022
๐Benefits were similar irrespective of baseline eGFR category. pic.twitter.com/6a9Mmx6C0u
15b) This suggests that the effects of #SGLT2i on progression of #CKD are greater in pts with higher levels of #albuminuria. pic.twitter.com/K5ExW9JBGw
— @CKD_ce (@ckd_ce) November 9, 2022
17) ๐secondary outcomes: 14% fewer all-cause hosp with #SGLT2i, but no significant diff in #HHF, #CV death, or all-cause death.
— @CKD_ce (@ckd_ce) November 9, 2022
๐Note low power for these comparisons, but point estimates are consistent with data from other #SGLT2i trials pic.twitter.com/avy9xbv4VQ
18b) Itโs c. #SGLT2i are very unlikely to cause significant hypoglycemia. Learn more about this from @edgarvlermamd's recent tweetorial, still available for ๐CE/#CME, at https://t.co/Bt6vghv1wx.
— @CKD_ce (@ckd_ce) November 9, 2022
20) Authors' conclusions: pic.twitter.com/vE4qI6yxOs
— @CKD_ce (@ckd_ce) November 9, 2022
22) Really, should any of us be surprised that Dr #Braunwald was right?
— @CKD_ce (@ckd_ce) November 9, 2022
๐https://t.co/TWCHJ3l97y pic.twitter.com/V5O2T975fu
23) Now proceed to https://t.co/7Q90SSYnYv & collect your 0.5hr CE/#CME. Follow us for more congress updates & expert-led #accredited renal education!
— @CKD_ce (@ckd_ce) November 9, 2022
Special ๐ to @willkidney, @RichardHaynes3, and to all the #EMPA_KIDNEY investigators! More details on https://t.co/XgkoUFWDJo