Kidney Week

Abstract: FR-PO814

Associations of Social Determinants of Health With SGLT2 Inhibitor Use in Kidney Transplant Recipients: A National Study

Session Information

• Transplantation: Clinical - Outcomes
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Lentine, Krista L., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Krista L. Lentine,

• Miyata, Kana N., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Kana N. Miyata,

• Caliskan, Yasar, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Yasar Caliskan,

• Sarabu, Nagaraju, University Hospitals, Cleveland, Ohio, United States

Nagaraju Sarabu,

• Dhindsa, Sandeep Singh Dhindsa, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Sandeep Singh Dhindsa Dhindsa,

• Axelrod, David, University of Iowa, Iowa City, Iowa, United States

David Axelrod,

• Xiao, Huiling, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Huiling Xiao,

• McAdams-DeMarco, Mara, New York University, New York, New York, United States

Mara McAdams-DeMarco,

• Bae, Sunjae, New York University, New York, New York, United States

Sunjae Bae,

• Hess, Gregory, Thomas Jefferson University, Philadelphia, Pennsylvania, United States

Gregory Hess,

• Joseph, Corey, Johns Hopkins University, Baltimore, Maryland, United States

Corey Joseph,

• Brennan, Daniel C., Johns Hopkins University, Baltimore, Maryland, United States

Daniel C. Brennan,

• Schnitzler, Mark, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Mark Schnitzler,

Background

Recent clinical trials demonstrate benefits of SGLT2 inhibitors (SGLT2i) in patients with chronic kidney disease, but data on SGLT2i use in kidney transplant (KTx) recipients are limited.

Methods

We examined a novel database linking SRTR registry data for KTx recipients (2000-2021) with outpatient fill records from a large pharmaceutical claims warehouse (2015-2021). Adult (age >18) KTx recipients treated with SGLT2i were compared to those who received other non-insulin diabetes mediations without SGLT2i. Characteristics associated with SGLT2i use were quantified by multivariable logistic regression (adjusted odds ratio, aOR).

Results

Among 18,988 KTx recipient treated with non-insulin diabetes agents in the study period, 2,224 filled an SGLT2i. Mean time from KTx to SGLT2i prescription was 6.7 yrs. vs.4.7 yrs. to first captured non-SGLT2i fill. SGLT2i use was more common in adults who were age >30 (compared to age 18–30 yrs.), Asian (aOR, 1.3), or had BMI>30 (aOR, 1.24), and trended higher with self-pay status (aOR, 1.52). SGLT2i use was lower in patients who were women (aOR, 0.88), Black (aOR, 0.88), other race (aOR, 0.75), publicly insured (aOR, 0.92), or had less than college education (aOR, 0.87). SGLT2i use in KTx patients increased dramatically in 2019-2021 (aOR, 5.64 vs prior yrs). [Figure]

Conclusion

SGLT2i use is increasing in KTx recipients, but varies with factors including race, education and insurance. While ongoing study is needed to define risks and benefits of SGLT2i use in KTx patients, attention should also focus on reducing treatment disparities related to social determinants of health rather than clinical indications.

Funding

• NIDDK Support