Separate and combined effects of semaglutide and empagliflozin on kidney oxygenation and perfusion in people with type 2 diabetes: a randomised trial
An erratum to this article was published (Diabetologia, Jul 2024 ↗)
Authors' conclusion
Our hypothesis, that semaglutide, empagliflozin or their combination improve kidney oxygenation, was rejected. On the contrary, empagliflozin induced a reduction in medullary kidney oxygenation. Semaglutide substantially reduced kidney perfusion without affecting oxygenation.
Study context
- Population
- People with T2D (HbA1c ≥48 mmol/mol [6.5%]) at high risk of CVD (age ≥50 years), Aarhus University Hospital, Denmark80 underwent MRI
- Participants
- 120 people
- Comparison
- Semaglutide, empagliflozin or their combination vs placebo
- Semaglutiden = 30
- Empagliflozinn = 30
- Combinationn = 30
- Placebon = 30reference
- Primary endpoint
- Change in kidney oxygenation (MRI R2*); co-primary with change in arterial stiffness (not reported here)
- Follow-up
- 32 weeks
Methodological detailsfour parallel groups, single-centre, partly blinded (semaglutide open label; empagliflozin and placebo blinded)
- Four parallel groups
- Single-centre
- Partly blinded (semaglutide open label; empagliflozin and placebo blinded)
Primary result
As reported in the abstract
Medullary R2* (higher R2* = lower oxygenation)
P = 0.016
- Common baseline medullary R2* across all four groups
- 24.5 (95% CI 23.9, 24.9) Hz
Secondary outcomes
Kidney perfusion · 32 weeks
- Semaglutide decreased perfusion in both cortex and medulla
Erythropoietin and haematocrit · 32 weeks
- Empagliflozin increased erythropoietin and haematocrit
GFR and urine albumin/creatinine ratio (UACR) · 32 weeks
- All three active treatments decreased GFR but not UACR
Safety
- Serious adverse events reported
- 10
- Semaglutide-associated obstipation
- 2
Original publication
Separate and combined effects of semaglutide and empagliflozin on kidney oxygenation and perfusion in people with type 2 diabetes: a randomised trial. Diabetologia. Published 6 February 2023. doi:10.
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