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Sodium-Glucose Co-Transporter 2 Inhibitors; Short-Term Outcome in Diabetic Kidney Transplant Recipients

J. Yagan1, T. S. Mahmoud1, A. Hasan2, O. Gheith1, n. El-Serwy1, S. Rida1, M. Mostafa1, M. Shaker1, P. Nair1, T. Alotaibi1

1Nephrology, Hamed Al-Essa Organ Transplant Center, Kuwait, Kuwait, 2Immunometabolism, Dasman Diabetes Center, Kuwait, Kuwait

Meeting: 2022 American Transplant Congress

Abstract number: 24

Keywords: Hyperglycemia, Kidney transplantation, Metabolic complications, Outcome

Topic: Clinical Science » Kidney » 35 - Kidney: Cardiovascular and Metabolic Complications

Session Information

Session Name: Kidney: Cardiovascular and Metabolic Complications I

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 5, 2022

Session Time: 3:30pm-5:00pm

 Presentation Time: 3:40pm-3:50pm

Location: Hynes Veterans Auditorium

*Purpose: The idea of using SGLT2i in kidney transplant recipients (KTR) is a legitimate one after the recent encouraging data for their use in other populations. Patient and graft survival are negatively affected by cardiovascular adverse events and the progressive reduction of graft function. KTR may benefit from the positive cardiovascular and renal outcomes of these drugs. Understandably, many transplant nephrologist may refrain from using SGLT2i because of the side effects profile reported with other patients.

*Methods: We collected retrospective data from records of KTR with type II diabetes (T2D) or post-transplant diabetes mellitus (PTDM) [n=98] who were receiving SGLT2i agents plus standard of care (SOC) and compared them to similar group of diabetic patients who were only receiving SOC [n=96].The inclusion criteria were KTR above 18 years of age with stable graft function who were on SGLT2i for at least three months. Patients with type I diabetes were not included.

*Results: There was no significant difference in demographic characteristics between the two groups.HbA1c was significantly reduced (-0.67%) in the SGLT2i group [p=0.0001] versus (-0.24%) in the SOC group [p= 0.0127]. The body mass index (BMI) was significantly reduced by 0.63 in the SGLT2i group [p=0.0106] versus an increase by 0.06 in the control group. Despite the initial dip in the estimated glomerular filtration rate (eGFR), there was a persistent and significant improvement towards the end of the year compared to the SOC group [P=0.0356]. We noticed a significant reduction of albuminuria in the study group (-20.28 mg/mmol creatinine) [p=0.0001] versus an increase by 4.48 mg/mmol creatinine in the control group.Patients tolerated the drug well without significant adverse effects (UTI, genital infections, DKA, rejection or cardiovascular events).

*Conclusions: The use of SGLT2i in managing diabetic patients post kidney transplantation is safe and has better short-term outcomes on renal function with comparable safety compared to standard of care therapy. A longer follow up is needed to assess the cardiovascular outcome.

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To cite this abstract in AMA style:

Yagan J, Mahmoud TS, Hasan A, Gheith O, El-Serwy n, Rida S, Mostafa M, Shaker M, Nair P, Alotaibi T. Sodium-Glucose Co-Transporter 2 Inhibitors; Short-Term Outcome in Diabetic Kidney Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/sodium-glucose-co-transporter-2-inhibitors-short-term-outcome-in-diabetic-kidney-transplant-recipients/. Accessed May 18, 2025.

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