a comparison of renal effects between empagliflozin and linagliptin in diabetic patients with chronic kidney disease: a randomized clinical trial

Objective: the current study aimed to compare the renal effects of empagliflozin with linagliptin combined with metformin in patients with type 2 diabetes mellitus (t2dm) and chronic kidney disease. materials and methods: we conducted a randomized clinical trial on diabetic patients aged over 18 years with chronic renal failure and an egfr between 20 to 60 ml/minutes/1.73 m2 corrected with the mdrd equation. between january and december 2023, a total of 150 cases in imam hossein hospital were randomized into two study arms of 75 cases receiving empagliflozin (10 mg/day) and metformin or linagliptin (5mg/day) and metformin for 6 months. the primary outcome was a change in chronic kidney disease (ckd) stage, while serum creatinine, fasting blood sugar (fbs), proteinuria, and blood pressure were evaluated at baseline, 3 and 6 months later. results: the mean age of participants was 62.20 (± 4.45) years and 50% of them were females. study indices including serum creatinine (p: 0.001), estimated glomerular filtration rate (egfr) (p: 0.001), fbs (p: 0.001), hga1c (p: 0.001), proteinuria (p: 0.001), and blood pressure (p: 0.001) reduced significantly over time in both groups. after adjustment for potential confounders, empagliflozin reduced the level of serum creatinine independent of other factors. conclusion: empagliflozin significantly reduces the level of serum creatinine compared to linagliptin in patients with t2dm and chronic renal failure.