Acute Effect of Empagliflozin on Fractional Excretion of Sodium and eGFR in Youth With Type 2 Diabetes
Bibliographic record
Abstract
Early markers of diabetic kidney disease (DKD), including hyperfiltration and elevated albumin excretion, are common in youth with type 2 diabetes (T2D) (1). Despite the morbidity associated with the development of future DKD in youth-onset T2D, pharmacotherapeutic options to lower hyperglycemia are limited to metformin and insulin, the only drugs approved for use in pediatric patients. Sodium–glucose cotransporter 2 (SGLT2) inhibitors reduce blood pressure, weight, and hyperglycemia in adults with T2D. Furthermore, a 38% reduction in cardiovascular death and a 39% reduction in incident or worsening nephropathy have been demonstrated with the selective SGLT2 inhibitor empagliflozin in patients with established cardiovascular disease (2,3). In young adults with type 1 diabetes, treatment with the SGLT2 inhibitor empagliflozin for 8 weeks was associated with natriuresis, increased renal vascular resistance, and reductions in glomerular filtration rate (GFR) (using inulin clearances) and renal blood flow (assessed by p -aminohippuric acid clearance) in those with baseline hyperfiltration (4). This renal hemodynamic profile suggested that the 20% reduction in hyperfiltration observed in this trial was due to afferent vasoconstriction and a decline in intraglomerular hypertension (4). In adults with T2D, the reduction in intraglomerular hypertension is typically reflected by a mean reduction in estimated GFR (eGFR) of 2–4 mL/min/1.73 m2 after treatment initiation, followed by a stabilization of eGFR decline compared …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".