{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:29:50Z","timestamp":1790868590960,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sodium\u2013glucose co\u2010transporter 2 (SGLT2) inhibitors improve clinical outcome in patients with heart failure (HF), but the mechanisms behind their beneficial effects are not yet fully understood. We examined the effects of empagliflozin on renal sodium and glucose handling in patients with acute HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      This study was a pre\u2010defined sub\u2010study of a double\u2010blind, randomized, placebo\u2010controlled, multicentre study (EMPA\u2010RESPONSE\u2010AHF). Patients were allocated within 24\u2009h of an acute HF admission to either empagliflozin 10\u00a0mg\/day (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a040) or placebo (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a039) for 30\u2009days. Markers of glucose and sodium handling were measured daily during the first 96\u2009h and at day 30. Patients were 76 (range 38\u201389) years old and 33% had diabetes. The use of loop diuretics during the first 96\u2009h was similar in both groups. Empagliflozin increased fractional glucose excretion with a peak after 24\u2009h (21.8% vs. 0.1%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), without affecting plasma glucose concentration, while fractional sodium and chloride excretion and urinary osmolality remained unchanged (\n                      <jats:italic>P<\/jats:italic>\n                      &gt;0.3 for all). However, empagliflozin increased plasma osmolality (delta osmolality at 72\u2009h: 5\u2009\u00b1\u20098 vs. 2\u2009\u00b1\u20095\u00a0mOsm\/kg;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.049). Finally, there was an early decline in estimated glomerular filtration rate with empagliflozin vs. placebo (\u221210\u2009\u00b1\u200912 vs. \u22122\u2009\u00b1\u200912\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.009), which recovered within 30\u2009days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with acute HF, empagliflozin increased fractional glucose excretion and plasma osmolality, without affecting fractional sodium excretion or urine osmolality and caused a temporary decline in estimated glomerular filtration rate. This suggests that empagliflozin stimulates osmotic diuresis through increased glycosuria rather than natriuresis in patients with acute HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2066","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T02:39:02Z","timestamp":1606703942000},"page":"68-78","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":140,"title":["Effects of empagliflozin on renal sodium and glucose handling in patients with acute heart failure"],"prefix":"10.1093","volume":"23","author":[{"given":"Eva M.","family":"Boorsma","sequence":"first","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost C.","family":"Beusekamp","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozine M.","family":"ter Maaten","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia M.","family":"Figarska","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.H. Jan","family":"Danser","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pharmacology Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J.","family":"van Veldhuisen","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"van der Meer","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiddo J.L.","family":"Heerspink","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The 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