Effects of semaglutide, empagliflozin and their combination on renal diffusion-weighted MRI and total kidney volume in patients with type 2 diabetes: a post hoc analysis from a 32 week randomised trial
Authors' conclusion
In a population with type 2 diabetes and high risk of CVD, semaglutide and empagliflozin significantly reduced cortical ADC compared with placebo, indicating microstructural changes in the kidneys. These changes were not associated with changes in GFR, albuminuria or inflammation. Further, we found a decrease in TKV in all active treatment groups, which was possibly mediated by a reduction in hyperfiltration. Our findings suggest that DWI-MRI may serve as a promising tool for investigating the underlying mechanisms of medical interventions in individuals with type 2 diabetes but may reflect effects not related to fibrosis.
Study context
- Population
- Patients with T2D and high risk of CVDrandomised into four groups
- Participants
- 80 patients
- Comparison
- Semaglutide, empagliflozin and their combination vs placebo
- Placebon = 20reference
- Empagliflozinn = 20
- Semaglutiden = 20
- Combination-therapyn = 20
Methodological detailssubstudy, placebo-controlled, four-arm
- Substudy
- Placebo-controlled
- Four-arm
Primary result
As reported in the abstract
Further findings
| Outcome | Decrease (×10-3 mm²/s) (95% CI) | P value | |
|---|---|---|---|
| ΔADC (cortical minus medullary ADC)Semaglutidevs PlaceboOnly semaglutide changed ΔADC significantly | −0.13 (−0.22 to −0.04) | P = 0.01 | |
| −0.3−0.2−0.100.1Difference, ×10-3 mm²/s (linear scale) |
| Outcome | Change (%) (95% CI) | P value | |
|---|---|---|---|
| Total kidney volume (TKV)Semaglutidevs Placebo | −3 (−5% to −0.3%) | P = 0.04 | |
| Total kidney volume (TKV)Empagliflozinvs Placebo | −3 (−5% to −0.4%) | P = 0.02 | |
| Total kidney volume (TKV)Combination-therapyvs Placebo | −5 (−8% to −2%) | P < 0.001 | |
| −10−505Difference, % (linear scale) |
Medullary apparent diffusion coefficient (ADC)
- No changes in medullary ADC in any group vs placebo
Total kidney volume (TKV)
- TKV changes associated with changes in GFR, albuminuria and HbA1c
Original publication
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