Empagliflozin is a medication primarily used for diabetes treatment, but researchers have investigated its effects on uric acid levels in people with chronic kidney disease (CKD) through the EMPA-KIDNEY trial. This extensive study involved 6,609 patients with CKD, examining how empagliflozin affects uric acid levels, a naturally occurring substance that can cause gout when elevated.
The trial was designed to compare patients taking empagliflozin against those taking a placebo over approximately two years. The researchers collected detailed data about kidney function, uric acid levels, and various other health markers throughout the study period.
Key findings from the research revealed that empagliflozin produced a modest reduction in blood uric acid levels. The medication’s effectiveness varied among different patient groups, showing better results in:
- Patients with better-functioning kidneys
- Individuals without diabetes
- Those who maintained good blood sugar control
- Patients not requiring insulin therapy
The study found that empagliflozin reduced uric acid levels by approximately 6%, which is notably less than traditional gout medications that can achieve 30-50% reductions. Despite this uric acid-lowering effect, the medication didn’t significantly reduce the occurrence of gout attacks during the study period.
An important scientific discovery was the mechanism by which empagliflozin affects uric acid levels. The medication works by increasing uric acid excretion through the kidneys and potentially reducing its production in the body. However, these effects were less pronounced in diabetic patients, possibly due to insulin’s influence on kidney uric acid transporters.
The researchers also discovered that the medication’s kidney-protective benefits weren’t directly linked to its uric acid-lowering effects, suggesting other protective mechanisms are at work. The study noted that empagliflozin might reduce the need for additional diuretic medications, which can affect body water levels.
While the uric acid-lowering effect was modest, the researchers concluded that empagliflozin could be valuable as a complementary therapy for CKD patients who are already taking other medications for high uric acid levels. This multi-beneficial approach could be particularly useful for patients who need to address multiple health issues simultaneously, including diabetes, kidney disease, and elevated uric acid levels.
Source: academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfae203/7758246
