{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:59:22Z","timestamp":1790438362957,"version":"4.1.0"},"reference-count":0,"publisher":"Romanian Society of Gastroenterology and Hepatology","issue":"3","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JGLD"],"abstract":"<jats:p>Background and Aims: Interventional studies directly targeting natriuresis in refractory cirrhotic ascites are scarce, and no prospective study has examined whether sodium-glucose transporter 2 (SGLT2) inhibitor-induced glucosuria is associated with changes in renal sodium handling. We conducted a randomized, open-label, proof-of-concept study to characterize the short-term natriuretic response to empagliflozin in patients with diabetes and refractory ascites\nMethods: Adults with type 2 diabetes, decompensated cirrhosis, and refractory ascites were randomized 1:1 to empagliflozin 10 mg once daily plus standard care or standard care alone for 10 days. The primary outcome was the between-group difference in mean change in fractional excretion of sodium (FENa, %) from baseline (Day 0) to the mean of post-baseline Days 1, 3, 7, and 10, estimated using a linear mixed-effects model. Key secondary outcomes included 24-hour urinary sodium excretion, 24-hour urine volume, and mean daily paracentesis volume.\nResults: Twenty-one participants were randomized (empagliflozin n=10; control n=11). In the empagliflozin group, the between-group difference in mean change in FENa from baseline to the post-baseline mean (days 1, 3, 7, and 10) was +0.44 percentage points (95%CI: 0.05-0.83; p=0.029). Empagliflozin increased 24-hour urinary sodium excretion by +92.1 mmol\/24 h (95%CI: 47.1-137.2) and 24-hour urine volume by + 822 mL\/24 h (95%CI: 403-1240) versus control. Mean daily paracentesis volume was 0.6 \u00b1 0.4 L\/day with empagliflozin and 1.3 \u00b1 0.6 L\/day with control (mean difference -0.70 L\/day, 95%CI: -1.17 to -0.23). No serious adverse events occurred.\nConclusions: In this open-label, proof-of-concept study, empagliflozin was associated with improved short-term natriuretic indices over 10 days in diabetic patients with decompensated cirrhosis and refractory ascites, without serious adverse events. Larger, blinded, longer-term trials are warranted to confirm these preliminary findings.<\/jats:p>","DOI":"10.15403\/jgld-6897","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:17:55Z","timestamp":1790435875000},"page":"393-399","source":"Crossref","is-referenced-by-count":0,"title":["Empagliflozin Promotes Natriuresis in Diabetic Patients with Cirrhotic Refractory Ascites: A Proof-of-Concept Study"],"prefix":"10.15403","volume":"35","author":[{"given":"Rongya","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyi","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longzhen","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianru","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-2727","authenticated-orcid":false,"given":"Zhongjie","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6121","published-online":{"date-parts":[[2026,9,26]]},"container-title":["Journal of Gastrointestinal and Liver Diseases"],"original-title":[],"link":[{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/download\/6897\/2400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/download\/6897\/2399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:22:37Z","timestamp":1790436157000},"score":1,"resource":{"primary":{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/view\/6897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,26]]}},"URL":"https:\/\/doi.org\/10.15403\/jgld-6897","relation":{},"ISSN":["1842-1121","1841-8724"],"issn-type":[{"value":"1842-1121","type":"electronic"},{"value":"1841-8724","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,26]]}}}