{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:52:59Z","timestamp":1791269579225,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney function decline in heart failure (HF) may accelerate during periods surrounding HF-related events, while sodium-glucose cotransporter 2 inhibitors slow kidney function decline. However, the temporal relationship between kidney function changes, HF-related events, and treatment effects has not been well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to explore kidney function trajectories around HF-related events and to assess whether empagliflozin modifies these changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In a pooled analysis of the EMPEROR-Reduced and EMPEROR-Preserved trials, we examined longitudinal changes in estimated glomerular filtration rate (eGFR) before and after HF-related events, defined as HF hospitalization or HF-related death. In the EMPEROR-Pooled analysis, HF-related events occurred in 12.7% of 9554 patients during a median follow-up of 20.9 months (14.7\u201328.6). Patients who experienced HF-related events had a steeper eGFR decline during the 12 months before the event than those without HF-related events: average \u22125.01\u2005ml\/min\/1.73\u2005m2\/year vs \u22121.93\u2005ml\/min\/1.73\u2005m2\/year; P &amp;lt; .001. During the 12 months after HF-related events, eGFR decline persisted at an average rate of \u22124.73\u2005ml\/min\/1.73\u2005m2\/year. These trajectories were not materially altered after adjustment for concurrent NYHA class or natriuretic peptide levels. Compared with placebo, empagliflozin slowed eGFR decline in patients without events (between-group difference, 0.94\u2005ml\/min\/1.73\u2005m2\/year) and before events (1.09\u2005ml\/min\/1.73\u2005m2\/year). The post-event difference was smaller (0.29\u2005ml\/min\/1.73\u2005m2\/year), without significant heterogeneity across periods (P &amp;gt; .10). Findings were consistent across trials and irrespective of prior HF hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag295","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:56:14Z","timestamp":1790855774000},"source":"Crossref","is-referenced-by-count":0,"title":["Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0008-2256","authenticated-orcid":false,"given":"Masatake","family":"Kobayashi","sequence":"first","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy ,","place":["France"]},{"name":"Department of Cardiology, Tokyo Medical University , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Duarte","sequence":"additional","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Baudry","sequence":"additional","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy ,","place":["France"]},{"name":"Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Monzo","sequence":"additional","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-6933","authenticated-orcid":false,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute , Dallas, TX ,","place":["USA"]},{"name":"Department of Medicine, University of Mississippi Medical Center , Jackson, MS ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Girerd","sequence":"additional","affiliation":[{"name":"CHRU de Nancy, CardioRenal Integration Clinical Investigation Center (CIC-P), INSERM, Universit\u00e9 de Lorraine, INSERM U1116 DCAC, INICRCT , 54500 Nancy 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