Abstract: FR-PO1201
Comparison of SGLT2 Inhibitor with GLP-1 Receptor Agonist vs. SGLT2 Inhibitor Alone in Kidney Transplant Recipients: Real-World Data of 1,915 Cases
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
Author
- Yu, Tung-Min, Taichung Veterans General Hospital, Taichung, Taichung City, Taiwan
Background
Kidney transplant recipients are at increased risk of cardiovascular disease and mortality, particularly in the presence of diabetes. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have demonstrated cardio-renal benefits in the general population; however, evidence regarding their combined use in kidney transplant recipients remains limited.
Methods
We conducted a multicenter, retrospective cohort study using the TriNetX Research Network to emulate a target trial. Adult kidney transplant recipients with diabetes who initiated SGLT2 inhibitor therapy within three months after transplantation were included. Patients were categorized into those receiving SGLT2i alone and those receiving combined SGLT2i and GLP-1 RA therapy. Propensity score matching was performed. Primary outcomes included all-cause mortality and major adverse cardiovascular events (MACE).
Results
After propensity score matching, 1,915 patients were included in each group with well-balanced baseline characteristics. Over a mean follow-up of 4.8 ± 2.6 years, combination therapy was associated with a significantly lower risk of all-cause mortality (adjusted hazard ratio [aHR] 0.39, 95% confidence interval [CI] 0.24–0.62) and MACE (aHR 0.67, 95% CI 0.48–0.94) compared with SGLT2i monotherapy.
Conclusion
In kidney transplant recipients with diabetes, combination therapy with SGLT2 inhibitors and GLP-1 receptor agonists was associated with improved cardiovascular and survival outcomes without compromising graft safety.
Acknowledgment
We are grateful to Taichung veterans general hospital for providing administrative, technical and funding support.