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

Moderate confidence

Some Concerns bias

Last updated June 11, 2026

Key Takeaway:

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.

Study at a Glance

What was studied

Empagliflozin effects on kidney injury biomarkers in early diabetic kidney disease

Participants

adults

Male, Female

Intervention

Empagliflozin

Outcomes

Urinary albumin-to-creatinine ratio, Urinary L-FABP, Serum VEGF, Serum ANGPTL2, Serum ANGPTL4, Serum adrenomedullin

Funding

Non-Industry Sponsored

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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 Summary

Intervention	Outcome	Measured Change	Study Effect
Empagliflozin (Medications)	Serum adrenomedullin (Clinical Outcomes)	No Change	Limited
Empagliflozin (Medications)	Serum ANGPTL2 (Clinical Outcomes)	Decrease	Strong
Empagliflozin (Medications)	Serum ANGPTL4 (Clinical Outcomes)	No Change	Limited
Empagliflozin (Medications)	Serum VEGF (Clinical Outcomes)	Decrease	Strong
Empagliflozin (Medications)	Urinary albumin-to-creatinine ratio (Clinical Outcomes)	Decrease	Mixed
Empagliflozin (Medications)	Urinary L-FABP (Glycemic Control)	No Change	Limited

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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