Abstract: FR-PO1203
SGLT2 Inhibitors After Kidney Transplantation: A Single-Center Experience
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
- Kreitler, Kristin, Henry Ford Hospital, Detroit, Michigan, United States
- Fitzmaurice, Mary Grace, Henry Ford Hospital, Detroit, Michigan, United States
- Mignosa, Gabriella, Henry Ford Hospital, Detroit, Michigan, United States
- Prashar, Rohini, Henry Ford Hospital, Detroit, Michigan, United States
Background
SGLT2 inhibitors (SGLT2i) provide metabolic and renal benefits in the general population, but long-term data in kidney transplant recipients (KTRs) remain limited.
Methods
We performed a retrospective cohort study of KTRs initiated on empagliflozin. Clinical and laboratory parameters were evaluated at baseline, 12 months, and 2 years. Outcomes included BMI, HbA1c, BP, eGFR, UACR, lipid profile, magnesium levels, and adverse events including UTIs.
Results
Baseline characertistics are summarized in Table 1. Among 130 treated KTRs, BMI decreased significantly at 12 months (31.6±6.1 to 29.6±4.9 kg/m2, p=0.033) and remained improved at 2 years (30.1±5.0, p=0.004). HbA1c remained stable over time (6.87±1.4 to 6.92±1.67 at 12 months and 6.97±1.50 at 2 years; p>0.8). Systolic and diastolic blood pressure trended lower without statistical significance. Renal function remained stable with no significant decline in eGFR over 2 years (55.2±20 to 51.3±18.3 mL/min/1.73m2 , p=0.231). UACR showed a downward trend (262.5 to 155.3 mg/g at 2 years), though not statistically significant. Lipid parameters remained unchanged. Serum magnesium significantly increased over time (1.7±0.24 to 1.91±0.25 mg/dL, p<0.001). UTIs were the most common adverse event (4.2% at 1 year, 10.9% at 2 years) and a frequent reason for discontinuation. Mortality events were infrequent and not clearly attributable to therapy.
Conclusion
In KTRs, SGLT2i use is associated with sustained weight reduction, stable glycemic control, preserved allograft function, and improved magnesium levels over 2 years. While UTIs remain an important safety consideration, overall findings support the use of SGLT2i in carefully selected transplant recipients.
Baseline Characteristics
| Age (median) | 60 |
| Race, n(%) AA Caucasian Hispanic Other | 60(46) 51(39) 7(6) 11(9) |
| Gender, male, n(%) | 85(65) |
| Days post-transplant at SGLT2i initiation, median (IQR) | 731.5(234,1806) |
| Type 2 diabetes pre-transplant, n(%) | 58(45) |
| New Onset diabetes after transplant (NODAT), n(%) | 48(37) |
| No history of diabetes, n(%) | 24(18) |
| Empagliflozin, n(%) | 129(99.2) |
| Glycosuria at baseline, n(%) | 34(26) |
| Hemoglobin A1C, %, median | 6.6 |
| Estimated glomerular filtration rate(eGFR), median | 54 |
| Urine albumin/creatinine ratio, mg/g, median | 61.5 |