Glucose-dependent diuresis in relation to improvements in renal-tubular markers of sodium-glucose cotransporter-2 inhibitors in hospitalized heart failure patients with diabetes
- 8 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Heart and Vessels
- Vol. 36 (7), 978-985
- https://doi.org/10.1007/s00380-020-01768-w
Abstract
Clinical parameters with correlation to diuretic effects after initiation of sodium-glucose cotransporter-2 (SGLT2) inhibitors are unclear. We aimed to identify the factors associated with the diuretic effect observed following the initiation of SGLT2 inhibitors in patients with diabetes having an acute heart failure (HF). Fifty-six patients included were hospitalized for acute HF with diabetes and started on SGLT2 inhibitors. Changes in urine volume (ΔUV) and blood/urine laboratory parameters before and during the first 4 days of therapy were evaluated. Data were prospectively obtained under clinically stable conditions after initial HF treatment. UV increased following the initiation of SGLT2 inhibitors [UV at baseline (BL): 1383 ± 479 mL/day; ΔUV over 4 days: + 189 ± 358 mL/day]. Multivariate analysis revealed no association between BL-hemoglobin A1c or BL-estimated glomerular filtration rate and ΔUV. Conversely, higher BL-fasting plasma glucose (FPG) and higher BL-urine N-acetyl-β-D-glucosaminidase (NAG) were associated with a higher ΔUV. ΔUV was inversely associated with ΔFPG and ΔNAG, and positively associated with Δurinary sodium excretion. Elevated FPG and NAG both improved over 4 days of treatment. In conclusion, the diuretic effect of SGLT2 inhibitors was glycemia-dependent, and was associated with a reduction in elevated renal-tubular markers in hospitalized HF complicated with diabetes.Keywords
This publication has 21 references indexed in Scilit:
- Randomized, double‐blind, placebo‐controlled, multicentre pilot study on the effects of empagliflozin on clinical outcomes in patients with acute decompensated heart failure (EMPA‐RESPONSE‐AHF)European Journal of Heart Failure, 2020
- Dapagliflozin in Patients with Heart Failure and Reduced Ejection FractionThe New England Journal of Medicine, 2019
- Sodium Glucose Co-transporter 2 Inhibitors and Heart FailureThe American Journal of Cardiology, 2019
- Importance of sodium-glucose cotransporter 2 inhibitor use in diabetic patients with acute heart failureTherapeutic Advances in Cardiovascular Disease, 2019
- Canagliflozin and Heart Failure in Type 2 Diabetes MellitusCirculation, 2018
- Sodium Glucose Cotransporter-2 Inhibition in Heart FailureCirculation, 2017
- Factors Affecting Canagliflozin-Induced Transient Urine Volume Increase in Patients with Type 2 Diabetes MellitusAdvances in Therapy, 2016
- Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME®trialEuropean Heart Journal, 2016
- Biology of Human Sodium Glucose TransportersPhysiological Reviews, 2011
- Renal Na+-glucose cotransportersAmerican Journal of Physiology-Renal Physiology, 2001