ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-OR55

Sodium-Glucose Cotransporter 2 Inhibitors in Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Lim, Jeong-Hoon, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Kwon, Soie, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Noh, Hee Won, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Jeon, Soojee, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Jung, Hee-Yeon, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Choi, Ji-Young, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Park, Sun-Hee, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Kim, Chan-Duck, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Kim, Yong-Lim, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Cho, Jang-Hee, Kyungpook National University School of Medicine, Daegu, Daegu, Korea (the Republic of)
Background

The effect and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i) have not been investigated in kidney transplant recipients (KTRs) with diabetes. We evaluated the impact of SGLT2i in a multicenter cohort of diabetic KTRs.

Methods

A total of 2083 KTRs with diabetes were enrolled from six transplant centers in Korea. Among them, 226 (10.8%) patients prescribed with SGLT2i for more than 90 days. The primary outcome was a composite outcome of all-cause mortality, death-censored graft failure, and serum creatinine doubling. An acute dip in estimated glomerular filtration rate (eGFR) over 10% was surveyed after SGLT2i use.

Results

During the mean follow-up of 62.9 ± 42.2 months, the SGLT2i group had a lower risk of primary composite outcome than the control group in the multivariate and propensity score-matched models (Figure 1; adjusted hazard ratio [aHR], 0.52; 95% confidence interval [CI], 0.29–0.94; P = 0.031 and aHR, 0.46; 95% CI, 0.24–0.89; P = 0.022, respectively). Multivariate analyses consistently showed a decreased risk of serum creatinine doubling in the SGLT2i group. The overall eGFR remained stable without the initial dip after SGLT2i use. A minority (15.6%) of the SGLT2i users showed acute eGFR dip during the first month, but the eGFR recovered thereafter (Figure 2). The risk factors for the eGFR dip were time from transplantation to SGLT2i usage and mean tacrolimus trough level.

Conclusion

SGLT2i improved a composite of all-cause mortality, death-censored graft failure, or serum creatinine doubling in KTRs. SGLT2i can be used safely and have beneficial effects on preserving graft function in diabetic KTRs.

Figure 1. Kaplan–Meier curves for the outcomes

Figure 2. Temporal changes in the eGFR of SGTL2i users due to eGFR dip.