ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: SA-PO498

Empagliflozin in Patients with Acute Heart Failure and Diuretic Resistance: Preliminary Data from the DRIP-AHF-1 Trial

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Marques, Pedro, McGill University Health Centre, Montreal, Quebec, Canada
  • Sharma, Abhinav, McGill University Health Centre, Montreal, Quebec, Canada
  • Mavrakanas, Thomas, McGill University Health Centre, Montreal, Quebec, Canada

Diuretic resistance is common in acute heart failure and associated with poor clinical outcomes. Chronic kidney disease (CKD) is a major determinant of diuretic resistance. Association of furosemide with sodium-glucose cotransporter 2 inhibitors can potentially overcome diuretic resistance in acute heart failure patients with CKD.


This is a prospective, single-arm, observational, open-label clinical trial. Patients admitted with acute heart failure with estimated glomerular filtration rate (eGFR) of 15-45mL/min/1.73m2 and diuretic resistance, defined as a urinary output (UO)<300mL in the 2 hours post 1-1.5mg/kg IV furosemide, were recruited. These patients received 25mg of empagliflozin 2 hours post a second IV furosemide bolus of 1-1.5mg/kg, administered at least 5 hours after the initial furosemide bolus.
Primary outcome is the 3-hour UO post furosemide+empagliflozin on the first day of the study, compared with furosemide alone. Secondary outcomes include fractional excretion of sodium (FENa) and total urinary sodium excretion.


From 32 patients screened, 6 patients met inclusion criteria and consented to participate. Median age was 80 (75-84) years, 67% were male, median ejection fraction was 40 (40-55) % and median baseline eGFR 18 (17-25) mL/min/1.73m2. All patients had a strong response to furosemide after empagliflozin administration (Table)


Our preliminary data shows that empagliflozin at a dose of 25mg, when added to high dose IV furosemide in patients with acute heart failure, low eGFR and diuretic resistance, is capable of increasing urinary output and urinary sodium excretion.

Data for the primary and secondary outcomes
Patient numberUO 3h post
UO 3h post
3h post FST
FENa 3h post
Na excretion
3h post FST
Na excretion
3h post Empa+FST

Empa - Empagliflozin; FENa - Fractional excretion of sodium; FST - Furosemide stress test; Na - Sodium; UO - Urinary output


  • Private Foundation Support