Abstract: FR-PO1206
Beyond Native Kidneys: The Emerging Role of SGLT2 Inhibitors in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - Rejection, Biomarkers, and Pharmacology
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Belal, Amer Ashaab, University of Florida College of Medicine, Gainesville, Florida, United States
- Schamber, Logan Nguyen, University of Florida College of Medicine, Gainesville, Florida, United States
- Kazory, Amir, University of Florida College of Medicine, Gainesville, Florida, United States
Background
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as therapeutic agents with cardiorenal benefits in a variety of patient populations. While the long-term clinical outcomes of kidney transplant recipients (KTRs) are often compromised by cardiovascular disease and kidney allograft dysfunction, they have been largely excluded from landmark studies of SGLT2 inhibitors due to concerns about the potential risk to graft function and the risk of adverse events. We sought to explore the available evidence on the effects of these agents in KTRs.
Methods
The PubMed database was searched for articles cited therein using the keywords “kidney transplant” and “SGLT2 inhibitor”. Data published from clinical trials between January 2020 and December 2025 were included. The studies were selected if 1) they explored the role of SGLT2 inhibitors in the KTRs and 2) included data on cardiorenal parameters. Pertinent clinical data and laboratory parameters (e.g., eGFR and adverse events) were extracted and reviewed.
Results
Nine studies with 10,042 participants (67% men) were included, with a mean age of 57.3 years. All studies were retrospective with follow-up of 12 to 63 months (mean: 27.8 ± 20.6). Various SGLT2 inhibitors were used in each. Hemoglobin A1C demonstrated a modest decrease in the intervention arm (from 7.8 to 7.3%). The baseline eGFR was 61.4 and 63.3 ml/min in the control and treatment groups, respectively, and the follow-up eGFR showed stability in the SGLT2 inhibitor group (59.8 and 65.3 ml/min, respectively). Graft rejection rates were 17.9 and 11.7% in the control and treatment groups, respectively. While there was significant variation in the reporting of adverse events, in general, they did not suggest an increased risk in the SGLT2 inhibitor group.
Conclusion
While SGLT-2 inhibitors are the mainstay of therapy in patients with chronic kidney disease, the evidence regarding their use in KTRs remains sparse, and current guidelines do not recommend routine use in this patient population. This study suggests that 1) the established benefits of SGLT-2inhibitors in patients with chronic kidney disease extend to select KTRs; there is a signal for stabilization in kidney allograft function, and 2) these agents do not seem to increase the rate of adverse events, such as urinary tract infections, in this patient population.