Session Name: Non-Organ Specific: Pharmacogenomics / Pharmacokinetics
Session Date & Time: None. Available on demand.
*Purpose: Post solid organ transplantation, diabetic kidney disease (DKD) can progress due to recurrent pre-transplantation diabetes or the development of post-transplantation diabetes mellitus (PTDM). This portends a higher risk of cardiovascular (CV) morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to slow DKD progression and decrease CV morbidity and mortality. Studies regarding the use of SGLT2i in abdominal transplant recipients (ATRs) are limited. This is a study to characterize the use of SGLT2i in ATRs.
*Methods: This is a single-center, retrospective analysis of ATRs initiated on SGLT2i. Chart review was performed to study demographics as well as assess for acute kidney injury (AKI), urinary tract infection (UTI), CV events, change in weight, hemoglobin A1c (HbA1c), and baseline kidney function.
*Results: SGLT2i were used in 20 ATRs, including 11 liver-, 8 kidney-, and 1 kidney after liver recipients. Recipients were white (55%) and male (65%), with an average age of 62 ± 7 years. Most patients had pre-transplant diabetes and 4 patients had PTDM (20%). Most patients were started on SGTL2i post-transplant at a median time of 48 months (IQR 30 – 82). Three patients were on SGLT2i pre-transplant. The most common agent was empagliflozin (55%). Most patients were initiated on SGLT2i by their endocrinologist (80%) or primary care physician. All patients were on additional therapy for blood glucose control, with a majority on insulin (89%). Most patients were maintained on a calcineurin inhibitor-based regimen (90%). After a median time from initiation to 378 months (IQR 168 – 588), average HbA1c and weight were lower and no differences were observed in kidney function (Table 2). AKI episode occurred in four patients, of which three were on diuretics. Uncomplicated UTI with Aerococcus occurred in one patient, with no episodes of fungal UTI. No episodes of amputation, CV event, or death were observed in this cohort
*Conclusions: Our retrospective analysis shows SGLT2i can be effectively and safely used in ATRs to derive the kidney and cardiac benefits. Larger clinical trials with long term follow up are warranted
To cite this abstract in AMA style:Hailemariam F, Yeager S, Schulte J, Singh P, Yadav A. Characterization of SGLT2 Inhibitor Use After Abdominal Transplant [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/characterization-of-sglt2-inhibitor-use-after-abdominal-transplant/. Accessed September 19, 2021.
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