During the last decade the cardiovascular and renal benefit of SGLT2 inhibitors came into spotlight of researchers and clinicians. The drug class exerts its action in the kidney’s proximal tubule cells by impeding the reuptake of glucose and sodium from the primary urine, thereby leading to increased glucosuria. This effect lowers plasma glucose levels, and further salutary outcomes as weight loss and decreasing blood pressure have been described. Regarding cardiac effects, the intake of SGLT2 inhibitors lead to left ventricular mass reduction, less hospitalizations, and decreased mortality. In contrary to the assumption of a renal function dependent effect, interestingly even individuals with severely impaired kidney function benefit from SGLT2 inhibitors.

We question whether the use of this drug class can be extended to hemodialysis patients, who’s kidneys are malfunctioning frequently do not produce urine. The Division of Nephrology and Dialysis coordinates a randomized, placebo-controlled multi-center trial on SGLT2 inhibitors in the setting of hemodialysis.

The recruitment will start in the first quarter of 2022 at the Medical University of Vienna and the Vienna Dialysis Center. Our protocol includes cardiac magnetic resonance imaging, echocardiography, bioimpedance spectroscopy and measurements of endogenous glucose production to capture potential changes of the heart, body fluid status and glucose metabolism within 6 months of study participation. By assessing the cardioprotective effect of empagliflozin, we intend to identify new treatment options for kidney failure patients on hemodialysis.  However, any study finding would yield in enhanced attendance of chronic kidney disease and hemodialysis patients.