Last updated September 1, 2026
Key finding
GFR decreased significantly (p = 0.003).
This study compared the renal hemodynamic effects of empagliflozin/linagliptin versus metformin/insulin glargine in type 2 diabetes patients, finding significant changes in renal function metrics.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study compared the renal hemodynamic effects of empagliflozin/linagliptin versus metformin/insulin glargine in type 2 diabetes patients, finding significant changes in renal function metrics.
Understanding the renal effects of different diabetes medications is crucial for optimizing treatment strategies in patients with type 2 diabetes. The significant changes in GFR and RVR observed in this study highlight the need for careful consideration of medication choices to prevent potential renal complications.
Limited sample size may affect generalizability. Short duration of follow-up may not capture long-term effects. Potential confounding factors not fully controlled.
Published in
Publication details and source links for this paper.
Christian O, Susanne J, Manuel K, et al. Renal hemodynamic effects of empagliflozin/linagliptin versus metformin/insulin glargine in type 2 diabetes. Cardiovascular Diabetology. 2021;20:178. doi:10.1186/s12933-021-01358-8
GFR decreased significantly by -6.3 ml/min (p = 0.003).
RPF remained unchanged (p = 0.536).
RVR decreased significantly by -7 mmHg (p = 0.001).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Empagliflozin and Linagliptin, Sequential addition of metformin followed by glipizide and insulin glargine and Change in Renal Plasma Flow (RPF), Change in Renal Vascular Resistance (RVR), Estimated glomerular filtration rate.
This study contributes evidence to
Primary intervention
Empagliflozin and Linagliptin
Primary outcomes
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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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.
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Related topics
6
Evidence pairs
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Related studies
Core evidence
The primary outcomes reported in this study.
Empagliflozin and Linagliptin → Change in Renal Plasma Flow (RPF)
Empagliflozin and Linagliptin → Change in Renal Plasma Flow (RPF)
Empagliflozin and Linagliptin → Change in Renal Vascular Resistance (RVR)
Empagliflozin and Linagliptin → Change in Renal Vascular Resistance (RVR)
Empagliflozin and Linagliptin → Estimated glomerular filtration rate
Empagliflozin and Linagliptin → Estimated glomerular filtration rate
Sequential addition of metformin followed by glipizide and insulin glargine → Change in Renal Plasma Flow (RPF)
Sequential addition of metformin followed by glipizide and insulin glargine → Change in Renal Plasma Flow (RPF)
Sequential addition of metformin followed by glipizide and insulin glargine → Change in Renal Vascular Resistance (RVR)
Sequential addition of metformin followed by glipizide and insulin glargine → Change in Renal Vascular Resistance (RVR)
Sequential addition of metformin followed by glipizide and insulin glargine → Estimated glomerular filtration rate
Sequential addition of metformin followed by glipizide and insulin glargine → Estimated glomerular filtration rate
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Empagliflozin and Linagliptin and Kidney Function, Sequential addition of metformin followed by glipizide and insulin glargine and Kidney Function.
This study contributes to the evidence on the following intervention-outcome relationships.
Diet and Nutrition
Medications
Curated evidence collections and hubs this study is part of.
All studies on Empagliflozin and Linagliptin
Contributes to Empagliflozin and Linagliptin evidence base.
All studies measuring Kidney Function
Measures Kidney Function as a key outcome.
All studies on Sequential addition of metformin followed by glipizide and insulin glargine
Contributes to Sequential addition of metformin followed by glipizide and insulin glargine evidence base.
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2 results
2 results
2 results
2 results
2 results
Generated from the study's connected evidence using Evidence Intelligence™.
Empagliflozin and Linagliptin may worsen estimated glomerular filtration rate or be associated with harm.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Estimated glomerular filtration rate
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate negative | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Sequential addition of metformin followed by glipizide and insulin glargine may worsen estimated glomerular filtration rate or be associated with harm.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Estimated glomerular filtration rate
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate negative | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Empagliflozin and Linagliptin appears to improve change in renal vascular resistance (RVR).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Change in Renal Vascular Resistance (RVR)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Empagliflozin and Linagliptin for change in renal plasma flow (RPF).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Change in Renal Plasma Flow (RPF)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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