Sthanu Subramanian: Empagliflozin and a Rise in Hematocrit
Sthanu Subramanian, Pediatrician, shared a post on X about a recent article by Motoaki Sano et al. published in Journal of Clinical Medicine Research, adding:
“Empagliflozin and a rise in Hematocrit.
The rise in hematocrit beyond simple diuresis in a patient on empagliflozin is primarily driven by enhanced erythropoiesis (increased red blood cell production), rather than just plasma volume contraction.
While diuresis causes a brief, initial spike in hematocrit, the sustained elevation seen over months is a direct result of stimulated erythropoietin (EPO) production.
Clinical Significance.
This dual mechanism – short-term hemoconcentration plus long-term erythropoiesis—typically raises hematocrit by 2% to 4%.
In large clinical trials like EMPA-REG OUTCOME, this increase in hematocrit and hemoglobin was identified as one of the single strongest statistical mediators of the drug’s profound cardiorenal benefits.
It directly improves systemic and myocardial oxygen delivery without increasing the risk of thrombotic events.”
Title: Increased Hematocrit During Sodium-Glucose Cotransporter 2 Inhibitor Therapy Indicates Recovery of Tubulointerstitial Function in Diabetic Kidneys
Authors: Motoaki Sano, Makoto Takei, Yasuyuki Shiraishi, Yoshihiko Suzuki
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