TY - JOUR

T1 - Evaluation of the effects of ezetimibe on albuminuria and kidney fat in individuals with type 2 diabetes and chronic kidney disease

AU - Heinrich, Niels Søndergaard

AU - Pedersen, Rune Ploegstra

AU - Vestergaard, Mark Bitsch

AU - Lindberg, Ulrich

AU - Andersen, Ulrik Bjørn

AU - Haddock, Bryan

AU - Hansen, Tine Willum

AU - Fornoni, Alessia

AU - Larsson, Henrik Bo Wiberg

AU - Rossing, Peter

N1 - Publisher Copyright: © 2023 John Wiley & Sons Ltd.

PY - 2023

Y1 - 2023

N2 - Aim: To investigate the effects of ezetimibe on the urine albumin creatinine ratio (UACR) and kidney parenchyma fat content (kidney-PF) in individuals with type 2 diabetes (T2D) and early chronic kidney disease. Materials and Methods: A randomized, double-blind, placebo-controlled study of ezetimibe 10 mg once daily for 16 weeks in individuals with T2D and a UACR of 30 mg/g or higher was conducted. Kidney-PF was assessed with magnetic resonance spectroscopy. Geometric mean changes from baseline were derived from linear regressions. Results: A total of 49 participants were randomized to ezetimibe (n = 25) or placebo (n = 24). Overall, mean ± standard deviation age was 67 ± 7 years, body mass index was 31 ± 4 kg/m2 and the proportion of men was 84%. The mean estimated glomerular filtration rate was 76 ± 22 mL/min/1.73m2 and median (first-third quartile) UACR was 95 (41-297) mg/g. Median kidney-PF was 1.0% (0.3%-2.1%). Compared with placebo, ezetimibe did not significantly reduce UACR (mean [95% confidence interval] change: −3% [−28%-31%]) or kidney-PF (mean change: −38% [−66%-14%]). In participants with baseline kidney-PF above the median, ezetimibe reduced kidney-PF significantly (mean change: −60% [−84%-−3%]) compared with placebo, while the reduction in UACR was not significant (mean change: −28% [−54%-15%]). Conclusions: Ezetimibe did not reduce the UACR or kidney-PF on top of modern T2D management. However, kidney-PF was reduced with ezetimibe in participants with high baseline kidney-PF.

AB - Aim: To investigate the effects of ezetimibe on the urine albumin creatinine ratio (UACR) and kidney parenchyma fat content (kidney-PF) in individuals with type 2 diabetes (T2D) and early chronic kidney disease. Materials and Methods: A randomized, double-blind, placebo-controlled study of ezetimibe 10 mg once daily for 16 weeks in individuals with T2D and a UACR of 30 mg/g or higher was conducted. Kidney-PF was assessed with magnetic resonance spectroscopy. Geometric mean changes from baseline were derived from linear regressions. Results: A total of 49 participants were randomized to ezetimibe (n = 25) or placebo (n = 24). Overall, mean ± standard deviation age was 67 ± 7 years, body mass index was 31 ± 4 kg/m2 and the proportion of men was 84%. The mean estimated glomerular filtration rate was 76 ± 22 mL/min/1.73m2 and median (first-third quartile) UACR was 95 (41-297) mg/g. Median kidney-PF was 1.0% (0.3%-2.1%). Compared with placebo, ezetimibe did not significantly reduce UACR (mean [95% confidence interval] change: −3% [−28%-31%]) or kidney-PF (mean change: −38% [−66%-14%]). In participants with baseline kidney-PF above the median, ezetimibe reduced kidney-PF significantly (mean change: −60% [−84%-−3%]) compared with placebo, while the reduction in UACR was not significant (mean change: −28% [−54%-15%]). Conclusions: Ezetimibe did not reduce the UACR or kidney-PF on top of modern T2D management. However, kidney-PF was reduced with ezetimibe in participants with high baseline kidney-PF.

KW - chronic kidney disease

KW - ectopic kidney fat

KW - ezetimibe

KW - magnetic resonance

KW - type 2 diabetes

U2 - 10.1111/dom.15146

DO - 10.1111/dom.15146

M3 - Journal article

C2 - 37278273

AN - SCOPUS:85161507835

VL - 25

SP - 2605

EP - 2615

JO - Diabetes, Obesity and Metabolism

JF - Diabetes, Obesity and Metabolism

SN - 1462-8902

IS - 9

ER -