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Abstract: PO2524

Efficacy and Safety of SGLT-2 Inhibitors for Treatment of Diabetes Mellitus Among Kidney Transplant Patients: A Systematic Review and Meta-Analysis

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Chewcharat, Api, Mount Auburn Hospital, Cambridge, Massachusetts, United States
  • Prasitlumkum, Narut, University of Hawai'i System, Honolulu, Hawaii, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
Background

The objective of this systematic review was to evaluate the efficacy and safety profiles of sodium glucose co-transporter 2 (SGLT-2) inhibitors for treatment of diabetes mellitus (DM) among kidney transplant (KT) recipients.

Methods

We conducted electronic searches in Medline, Embase, Scopus, and Cochrane databases from inception through April 2020 to identify studies that investigated efficacy and safety of SGLT-2 inhibitors in KT patients with DM. Study results were pooled and analyzed utilizing random-effects model.

Results

Eight studies with 132 patients [baseline estimated glomerular filtration rate (eGFR) of 64.5±19.9 mL/min/1.73m2] treated with SGLT-2 inhibitors were included in our meta-analysis. SGLT-2 inhibitors demonstrated a significantly lower HbA1C (WMD = -0.56% [95%CI: -0.97, -0.16]; p=0.007) and body weight (WMD = -2.16 kg [95%CI: -3.08, -1.24]; p<0.001) at end of study compared to baseline level. There were no significant changes in eGFR, serum creatinine, urine protein creatinine ratio, and blood pressure. By subgroup analysis, empagliflozin demonstrated a significant reduction in BMI and body weight. Canagliflozin revealed a significant decrease in HbA1C and systolic blood pressure. In terms of safety profiles, 14 patients had urinary tract infection. Only 1 had genital mycosis, 1 had acute kidney injury, and 1 had cellulitis. There were no reported cases of euglycemic ketoacidosis or acute rejection during the treatment.

Conclusion

Among KT recipients with excellent kidney function, SGLT-2 inhibitors for treatment of DM are effective in lowering HbA1C, reducing body weight, and preserving kidney function without reporting of serious adverse events, including euglycemic ketoacidosis and acute rejection.