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Twenty years ago, a group of medications which block a biological system, called the renin-angiotensin system (RAS), were shown to protect the kidney and the heart. Because of these clinical trials, these medications are now widely used (and participants may be taking one: their names end in ‘–pril’ or ‘–sartan’). These simple treatments have meant some people have not needed to start dialysis and have saved lives.

However, despite taking RAS blockers, many people with kidney problems continue to develop worsening of their kidney disease and/or heart problems. Scientists are searching for new treatments to reduce the remaining risk of kidney and heart problems in people with kidney disease.

Empagliflozin molecule

There is now a new medication called empagliflozin (pronounced em-pa-gli-FLOE-zin) which was originally developed to treat high blood sugar in people with diabetes, but has recently been shown to have beneficial effects on both the heart and kidney.

Empagliflozin causes blood sugar (equivalent to 10 teaspoons a day) to pass into the urine. It likely also increases the amount of salt (sodium) passing into the urine. This results in a modest fall in body weight and blood pressure.

Importantly, a large clinical trial has shown that empagliflozin reduces the number of deaths from heart disease in people who already have both heart disease and type 2 diabetes. Because of these results, empagliflozin is used in selected patients with diabetes around the world.

The same study suggested empagliflozin might reduce kidney problems. From the way we think the pills work, there is good reason to believe this new medication could benefit people who have kidney disease, whether they have diabetes or not.