Abstract: SA-PO0524
Kidney Outcomes with Empagliflozin 10 mg vs. 25 mg: A Large, Real-World Retrospective Cohort Study
Session Information
- Top Trainee Posters - 3
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 01:48 PM - 01:54 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Saade, Marie Christelle, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Younis, Nour Khaled, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Jin, Yujia, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- McAdams, Meredith C., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background
Empagliflozin has demonstrated established renal protective effects in patients with chronic kidney disease as shown in the EMPA-KIDNEY trial. However, despite frequent dose escalation to 25 mg in clinical practice, evidence supporting additional renal benefit beyond the standard 10 mg dose remains limited.. We therefore evaluated dose-related renal outcomes in a large real-world cohort.
Methods
We performed a retrospective longitudinal cohort study of outpatients prescribed empagliflozin at The University of Texas Southwestern Medical Center. Patients receiving 10 mg versus 25 mg were compared using longitudinal mixed-effects models evaluating trajectories of serum creatinine, eGFR, urine albummin to creatinine ratio (UACR), and hemoglobin A1C. Demographics, comorbidities, medications, laboratory values, and clinical outcomes including AKI, hospitalization, and death at multiple time points were obtained. Sensitivity analyses were performed among patients treated with empagliflozin for ≥1 year.
Results
Among 6,937 individuals included, 5,697 received empagliflozin 10 mg and 1,240 received 25 mg. Across longitudinal follow-up, renal trajectories were comparable between dosing groups, with no clinically meaningful differences in eGFR decline, serum creatinine, or albuminuria over time. 44.2% of the cohort were female, 26.1% were black, and 13.9% were Hispanic. 29.9% had CKD at baseline with baseline eGFR being 69.9 mL/min/1.73 m^2. Findings remained consistent in sensitivity analyses restricted to individuals treated for ≥1 year. Although AKI and hospitalization rates were higher in the 10 mg cohort, this group had substantially greater baseline comorbidity burden, including higher prevalence of CKD (32.4% vs 18.5%, p<0.001), heart failure (40.7% vs 16.6%, p<0.001), and coronary artery disease (30% vs 19.2%, p<0.001).
Conclusion
In this large real-world cohort, empagliflozin 25 mg did not demonstrate incremental renal benefit compared with the standard 10 mg dose. These findings suggest that dose escalation may not provide additional renal functional benefit, supporting the effectiveness of 10 mg empagliflozin for renal protection in clinical practice.