Real-world analysis of sodium-glucose cotransporter-2 inhibitors in kidney transplant recipients

Sodium-glucose cotransporter-2 (SGLT2) inhibitors lower blood sugar levels and have additional beneficial effects on kidney and heart health for individuals with and without diabetes, but little is known about the safety and efficacy of these medications in kidney transplant recipients. Research that examined this will be presented at ASN Kidney Week 2023 November 1–5.

For the study, investigators analyzed the electronic medical records of 3,450 adult kidney transplant recipients treated with SGLT2 inhibitors who were matched to 3,450 similar patients who did not receive SGLT2 inhibitors, using a statistical technique called propensity matching adjusted for demographic data, baseline heart disease and blood test.

Kidney transplant patients treated with SGLT2 inhibitors were 59%, 64%, 33%, and 40% less likely to experience kidney transplant rejection, kidney transplant failure, major adverse cardiac events, and mortality, respectively, over 3 years. They were also 44% less likely to experience urinary tract infections.

"To date, all major SGLT2 inhibitor studies have excluded kidney transplant patients. This study was the largest observational study demonstrating the benefits of SGLT2 inhibitors in patients with kidney transplants," said corresponding author Nageen, Anwar, MD, of the Liverpool University Hospitals NHS Foundation Trust.

"This study is a big step towards qualifying transplant patients to benefit from the many positive effects of SGLT2 inhibitor use and sets the precedence for a randomized controlled trial to evaluate the long-term kidney and cardiovascular outcomes of SGLT2 inhibitor therapy in kidney transplant patients."