Abstract: FR-PO1062
SGLT2 Inhibitors and GLP-1 Receptor Agonists in Kidney Transplantation: Systematic Review and Meta-Analysis
Session Information
- Transplantation: Clinical - Pharmacology and Nonkidney Solid Organ Transplants
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Lee, Sul A, Massachusetts General Hospital, Boston, Massachusetts, United States
- Verhoeff, Rucháma, Massachusetts General Hospital, Boston, Massachusetts, United States
- Hullekes, Frank E., Massachusetts General Hospital, Boston, Massachusetts, United States
- Hansrivijit, Panupong, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Riella, Leonardo V., Massachusetts General Hospital, Boston, Massachusetts, United States
Background
Kidney transplant (KT) recipients experience high rates of cardiovascular disease, allograft dysfunction, and diabetes, negatively impacting long-term outcomes. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) provide cardiovascular and kidney benefits in non-KT recipients, but evidence in KT recipients remains limited. This systematic review and meta-analysis provide updated evidence on the efficacy and safety of SGLT2i and GLP-1RA on KT recipients.
Methods
A comprehensive search of MEDLINE, Embase, and Cochrane databases was conducted through February 27, 2025. Data extraction, risk of bias assessment, and meta-analysis were performed using standardized methods with a random-effects model.
Results
A total of 32 studies, including 7,834 KT recipients, were analyzed, comprising 21 studies (3,856 patients) on SGLT2i and 12 studies (3,978 patients) on GLP-1RA. Their use was associated with reduced mortality and improved cardiovascular and kidney outcomes in matched control studies (Table 1). Both agents promoted weight loss [SGLT2i: standardized mean difference (SMD) -0.59 (95% CI: -1.04, -0.15); GLP-1RA: SMD -0.27 (95% CI: -0.44, -0.10)] and HgbA1C reduction [SGLT2i: mean difference (MD) -0.33% (95% CI: -0.55%, -0.12%); GLP-1RA: MD -0.48% (95% CI: -0.82%, -0.13%)], while maintaining stable kidney function. SGLT2i increased serum magnesium levels and reduced uric acid levels. Safety analysis showed no increased risk of infections (SGLT2i) or pancreatitis (GLP-1RA).
Conclusion
SGLT2i and GLP-1RA were associated with improved survival, cardiovascular, and kidney outcomes with a favorable safety profile. Future randomized controlled trials are necessary to confirm the efficacy and safety in this high-risk population.
Funding
- Other NIH Support