Pharmacological TreatmentsComplications

Research Summary

Analyzed using Evidence Intelligence™

Empagliflozin may reduce kidney disease biomarkers but shows mixed effects on albumin in early diabetes

Last updated June 11, 2026

Key finding

Empagliflozin group - Placebo group: -0.3643, 95% CI: -0.7571 to 0.0285, p=0.0686

This study tested the SGLT2 inhibitor empagliflozin in 79 people with type 2 diabetes and early kidney disease over 24 weeks. While empagliflozin showed early improvements in albumin excretion at 4 and 12 weeks, the difference was not significant by 24 weeks. However, it did reduce certain hypoxia-related proteins in the blood that may contribute to kidney damage.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

Randomized Controlled Trial

Follow-up

Medium-Term (3–12 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

Clinical relevance

Early diabetic kidney disease is a leading cause of kidney failure and cardiovascular disease. Understanding how SGLT2 inhibitors protect kidneys beyond glucose control is important for optimizing treatment strategies. This study suggests that empagliflozin may work partly by reducing hypoxia-induced proteins that promote abnormal blood vessel growth and kidney scarring, offering insight into the mechanisms behind the kidney-protective effects observed in larger clinical trials like EMPA-KIDNEY.

Keep in mind

Small sample size (79 participants) may have limited statistical power to detect ACR reduction Relatively short duration (24 weeks) may not capture long-term kidney protection effects Single spot urine test for ACR rather than standard three-day measurement increases biological variability Biomarkers measured in blood may not fully represent kidney tissue activity

Main Effects

↓ Serum VEGF (vascular endothelial growth factor)

↓ Serum ANGPTL2 (angiopoietin-like protein 2)

↔ Urinary albumin-to-creatinine ratio (trend toward reduction, not significant at 24 weeks)

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Empagliflozin and Serum ANGPTL2, Serum ANGPTL4, Serum VEGF, and 3 more.

This study contributes evidence to

Intervention

Empagliflozin

Outcome

Serum ANGPTL2

Evidence topic

Diabetic Kidney Disease

Primary intervention

Empagliflozin

Primary outcomes

Serum ANGPTL2
Serum ANGPTL4
Serum VEGF

Evidence topics

Diabetic Kidney Disease Inflammatory and Vascular Markers SGLT2 Inhibitors

Primary intervention

Empagliflozin

Primary outcomes

Serum ANGPTL2 Serum ANGPTL4 Serum VEGF

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

Evidence pairs

Relationships

Evidence topics

contributes_evidence

Editorial context

Why this study matters

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Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 72

Why it is useful

Contributes to 6 evidence relationships
Includes primary outcome data
Linked to 3 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

SGLT2 Inhibitors and Kidney Function

Related evidence

Evidence relationship

SGLT2 Inhibitors and Adipokine and Angiogenic Markers

Save evidence

Evidence topic

Diabetic Kidney Disease

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

Serum adrenomedullin

Empagliflozin → Serum adrenomedullin

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 55; Slightly Positive
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Serum ANGPTL2

Empagliflozin → Serum ANGPTL2

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 100; Very Positive
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Serum ANGPTL4

Empagliflozin → Serum ANGPTL4

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 55; Slightly Positive
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Serum VEGF

Empagliflozin → Serum VEGF

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 100; Very Positive
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Urinary albumin-to-creatinine ratio

Empagliflozin → Urinary albumin-to-creatinine ratio

Evidence Intelligence™

EvidenceScore™: Moderate; Score 69 · Based on 2 studies
ImpactScore™: 50; Neutral
ConsistencyScore™: 100; consistent

Based on 2 studies

Add to Evidence Tracker

Urinary L-FABP

Empagliflozin → Urinary L-FABP

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 55; Slightly Positive
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Evidence Library

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Keep in Mind

Small sample size (79 participants) may have limited statistical power to detect ACR reduction Relatively short duration (24 weeks) may not capture long-term kidney protection effects Single spot urine test for ACR rather than standard three-day measurement increases biological variability Biomarkers measured in blood may not fully represent kidney tissue activity

Between the Lines

Small sample size (79 participants) may have limited statistical power to detect ACR reduction Relatively short duration (24 weeks) may not capture long-term kidney protection effects Single spot urine test for ACR rather than standard three-day measurement increases biological variability Biomarkers measured in blood may not fully represent kidney tissue activity

Evidence Library

Build your evidence library

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on SGLT2 Inhibitors and Kidney Function, SGLT2 Inhibitors and Serum adrenomedullin.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Medications

Detailed evidence

SGLT2 Inhibitors → Kidney Function

Medications

Evidence Intelligence™

EvidenceScore™: Moderate; Score 69 · Based on 2 studies
ImpactScore™: 50; Neutral
ConsistencyScore™: 100; consistent

Based on 2 studies

View evidence

Medications

Detailed evidence

SGLT2 Inhibitors → Serum adrenomedullin

Medications

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 55; Slightly Positive
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

View evidence

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

Kidney Function Evidence Hub

All studies measuring Kidney Function

2 studies

outcome_hub

Measures Kidney Function as a key outcome.

SGLT2 Inhibitors Evidence Hub

All studies on SGLT2 Inhibitors

2 studies

intervention_hub

Contributes to SGLT2 Inhibitors evidence base.

Serum adrenomedullin Evidence Hub

All studies measuring Serum adrenomedullin

1 studies

outcome_hub

Measures Serum adrenomedullin as a key outcome.

Recent Diabetes Research

Latest published studies

recency_collection

Published within the last 2 years.

Explore more in Evidence Explorer

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All studies on Empagliflozin and Urinary albumin-to-creatinine ratio

Intervention: EmpagliflozinOutcome: Urinary albumin-to-creatinine ratio

2 results

All studies on Empagliflozin and Serum adrenomedullin

Intervention: EmpagliflozinOutcome: Serum adrenomedullin

1 results

All studies on Empagliflozin

Intervention: Empagliflozin

2 results

All studies measuring Urinary albumin-to-creatinine ratio

Outcome: Urinary albumin-to-creatinine ratio

2 results

All studies measuring Serum adrenomedullin

Outcome: Serum adrenomedullin

1 results

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does SGLT2 Inhibitors improve kidney function?

Strong Evidence

SGLT2 Inhibitors may improve Kidney Function.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

1
Urinary albumin-to-creatinine ratio
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | neutral | ConsistencyScore™ Consistent | 1 study

Why this answer: This answer is based on 8 supporting studies with consistent results and a positive effect signal.

Limitations

Population details are unavailable.

View Full Evidence

Does SGLT2 Inhibitors improve adipokine and angiogenic markers?

Strong Evidence

SGLT2 Inhibitors may improve Adipokine and Angiogenic Markers.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

1
Serum ANGPTL2
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
2
Serum VEGF
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
3
Serum ANGPTL4
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 7 supporting studies with consistent results and a positive effect signal.

Limitations

Population details are unavailable.

View Full Evidence

Does Empagliflozin improve serum adrenomedullin?

Emerging Evidence

Empagliflozin may improve Serum adrenomedullin.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Serum adrenomedullin
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Empagliflozin improve urinary l-fabp?

Emerging Evidence

Empagliflozin may improve Urinary L-FABP.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Urinary L-FABP
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

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Next steps

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Evidence topics

Follow the topics this study contributes to.

Diabetic Kidney Disease Evidence Hub Inflammatory and Vascular Markers Evidence Hub SGLT2 Inhibitors Evidence Hub

Explore in Evidence Explorer

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All studies on Empagliflozin and Urinary albumin-to-creatinine ratio All studies on Empagliflozin and Urinary L-FABP All studies on Empagliflozin and Serum ANGPTL2 All studies on Empagliflozin and Serum ANGPTL4

Related research

Read related research summaries.

Empagliflozin improves heart function in type 2 diabetes patients Empagliflozin improves glycemic control in type 2 diabetes patients Empagliflozin reduces liver fat in diabetes patients Empagliflozin improves glycemic control in HNF1A-MODY Empagliflozin improves glycemic control in type 1 diabetes patients

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