Empagliflozin attenuates acute kidney injury after myocardial infarction in diabetic rats

Sci Rep. 2020 Apr 29;10(1):7238. doi: 10.1038/s41598-020-64380-y.

Abstract

Acute kidney injury (AKI) predicts poor prognosis in patients with acute myocardial infarction (MI) and diabetes mellitus (DM) is an independent risk factor of AKI. Recent clinical studies have shown the beneficial effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on cardiovascular and renal outcomes in patients with DM. We recently reported that canagliflozin normalized susceptibility of diabetic rats to AKI after acute MI via β-hydroxybutyrate-mediated suppression of NOX expression. Here we examined whether the same renoprotective effect is shared by empagliflozin. Serum creatinine levels were not changed by MI induced by coronary artery occlusion in LETO, non-diabetic control rats, and OLETF, obese type 2 diabetic rats. However, immunohistochemistry revealed that MI increased renal expression of NGAL and KIM-1, early markers of tubular injury, by 3.2-fold and 2.6-fold, respectively, in OLETF. These increases in injury markers were not observed in LETO. Pretreatment with empagliflozin of OLETF for 2 weeks improved hyperglycemia, increased blood β-hydroxybutyrate level, and suppressed MI-induced expression of NGAL and KIM-1. Empagliflozin suppressed upregulation of NOX2 and NOX4 in the kidney of OLETF. Taken together with the results of our previous study, it was concluded that treatment with the SGLT2 inhibitor protects the diabetic kidney from MI-induced AKI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury* / drug therapy
  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / metabolism
  • Acute Kidney Injury* / pathology
  • Animals
  • Benzhydryl Compounds / pharmacology*
  • Diabetes Complications* / drug therapy
  • Diabetes Complications* / metabolism
  • Diabetes Complications* / pathology
  • Diabetes Mellitus, Experimental* / drug therapy
  • Diabetes Mellitus, Experimental* / metabolism
  • Diabetes Mellitus, Experimental* / pathology
  • Glucosides / pharmacology*
  • Kidney* / metabolism
  • Kidney* / pathology
  • Male
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / drug therapy
  • Myocardial Infarction* / metabolism
  • Myocardial Infarction* / pathology
  • Rats

Substances

  • Benzhydryl Compounds
  • Glucosides
  • empagliflozin