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Kidney Week

Abstract: TH-PO156

Linagliptin May Be Safe After Kidney Transplant

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Attallah, Nizar M., Cleveland Clinic Abu Dhabi , Abu Dhabi, United Arab Emirates
  • Yassine, Lina, Imperial College of London Diabetes Center Abu Dhabi, Abu Dhabi, United Arab Emirates
Background

The incidence and prevalence of end-stage renal disease (ESRD) is increasing. The most common cause of ESRD is diabetes mellitus (DM). Kidney transplantation offers better quality of life and survival for patients with ESRD. Patients could develop post-transplant DM (PTDM). Management of DM after transplantation (whether the patient had it from before or after the transplant) is a challenge. Different medications could be used to manage PTDM. Those medications have good safety and efficacy record in general population and patients with mild degrees of kidney disease.

Methods

We conducted a retrospective single center analysis of safety and efficacy of Linagliptin post kidney transplantation. The study was approved by institutional review board. We collected data (demographics, laboratory tests and any symptoms or hospitalizations) for 28 consecutive patients for 16 months.

Results

All 28 patients were initiated on Linagliptin throughout the study period. Patients’ average age was 62. Fifteen were females and all from Middle Eastern decent and had kidney transplant on average of 25 months when they were included in the study. Twelve patients had DM before the transplant and the rest had PTDM. 13 patients were on metformin and 8 were on insulin while the rest were not on any other medications at the start of the study. Baseline average creatinine was 1.5 mg/dL (132.9 mmol/L) and glycated hemoglobin (HbA1c) of 8.2 g/dL at the start of the study while creatinine was 1.6 mg/dL (141.8 mmol/L) and HbA1c was 7.4 g/dL at the end. HbA1c dropped 0.8 on average within 5 weeks of starting Linagliptin and was maintained at the same level for the rest of the study. Urine protein did not change significantly throughout the study. Two patients developed acute myocardial infarction during the study and a third patient was hospitalized with an opportunistic infection. Two patients had urinary tract infections. 3 patients had nausea and vomiting after starting Linagliptin but that resolved 2 weeks later. No allergic reactions, hypoglycemia or acute pancreatitis episodes were reported. The average weight and body mass index did not change throughout the study. None of the patients stopped the medication.

Conclusion

In this retrospective analysis, Linagliptin seems to be safe and efficacious after kidney transplantation. It can be considered in the management of diabetes post kidney transplantation.