Heart failure & cardiomyopathies

Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis

Eur J Heart FailPublished Pooled analysis of trials

Authors' conclusion

Across the LVEF spectrum, kidney function decline accelerated before HF-related events and remained rapid thereafter. Empagliflozin attenuated eGFR decline without evidence of heterogeneity across periods.

Study context

Population
Patients with heart failure (HF) across the LVEF spectrum (EMPEROR-Reduced and EMPEROR-Preserved trials)
Participants
9,554 patients
Comparison
Empagliflozin vs placebo
Outcome
Longitudinal changes in eGFR before and after HF-related events (HF hospitalization or HF-related death)
Follow-up
Median 20.9 months (14.7-28.6)
Methodological detailsEMPEROR-Reduced and EMPEROR-Preserved trials
  • EMPEROR-Reduced and EMPEROR-Preserved trials

Pooled result

As reported in the abstract

Difference in eGFR decline (empagliflozin vs placebo)

Between-group difference

0.94 ml/min/1.73 m²/year

in patients without events

Between-group difference

1.09 ml/min/1.73 m²/year

before events

Between-group difference

0.29 ml/min/1.73 m²/year

post-event; The post-event difference was smaller

Further pooled results

Average, ml/min/1.73 m²/year

OutcomeHF-related eventsNo HF-related eventsP value
eGFR decline during 12 months before HF-related eventSteeper eGFR decline during the 12 months before the event−5.01−1.93P < 0.001
  • Estimated glomerular filtration rate (eGFR) decline during 12 months before HF-related event: not materially altered after adjustment for concurrent NYHA class or natriuretic peptide levels

HF-related events · median follow-up 20.9 months (14.7-28.6)

HF-related events (HF hospitalization or HF-related death)
12.7%

eGFR decline during 12 months after HF-related events

Average rate of eGFR decline
−4.73 ml/min/1.73 m²/year

Original publication

Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis. Eur J Heart Fail. Published 6 October 2026. doi:10.1093/ejhf/xuag295

Summarised from the published abstract; every number is checked against it

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