Sodium-glucose cotransporter-2 inhibitor therapy in kidney transplant patients with type 2 or post-transplant diabetes : an observational multicentre study
Sánchez Fructuoso, Ana Isabel (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Bedia Raba, Andrea (Hospital de Cruces (Barakaldo, Biscaia))
Banegas Deras, Eduardo (Hospital Universitario Central de Asturias)
Vigara Sánchez, Luis A. (Hospital Puerta del Mar (Cadis))
Valero Cecilio, Rosalía San (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Franco Esteve, Antonio (Hospital General Universitari d'Alacant)
Cruzado Vega, Leonidas (Hospital General Universitario de Elche)
Gavela Martínez, Eva (Hospital Peset)
González Garcia, María E. (Hospital Universitario La Paz (Madrid))
Saurdy Coronado, Pablo (Complejo Hospitalario Universitario de Albacete)
Valencia Morales, Nancy D. (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Zarraga Larrondo, Sofía (Hospital de Cruces (Barakaldo, Biscaia))
Ridao Cano, Natalia (Hospital Universitario Central de Asturias)
Mazuecos Blanca, Auxiliadora (Hospital Puerta del Mar (Cadis))
Hernández Marrero, Domingo (Hospital Regional Universitario Carlos Haya (Málaga))
Beneyto Castello, Isabel (Hospital Universitari i Politècnic La Fe (València))
Ramos, Javier Paul (Hospital Universitario Miguel Servet (Saragossa))
Sierra Ochoa, Adriana (Hospital del Mar (Barcelona, Catalunya))
Facundo, Carme (Institut d'Investigació Biomèdica Sant Pau)
González Roncero, Francisco (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Torres Ramírez, Armando (Hospital Universitario de Canarias (La Laguna))
Cigarrán Guldris, Secundino (Hospital Da Costa Burela)
Pérez Flores, Isabel (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have cardioprotective and renoprotective effects. However, experience with SGLT2is in diabetic kidney transplant recipients (DKTRs) is limited. This observational multicentre study was designed to examine the efficacy and safety of SGLT2is in DKTRs. The primary outcome was adverse effects within 6 months of SGLT2i treatment. Among 339 treated DKTRs, adverse effects were recorded in 26%, the most frequent (14%) being urinary tract infection (UTI). In 10%, SGLT2is were suspended mostly because of UTI. Risk factors for developing a UTI were a prior episode of UTI in the 6 months leading up to SGLT2i use {odds ratio [OR] 7. 90 [confidence interval (CI) 3. 63-17. 21]} and female sex [OR 2. 46 (CI 1. 19-5. 03)]. In a post hoc subgroup analysis, the incidence of UTI emerged as similar in DKTRs treated with SGLT2i for 12 months versus non-DKTRs (17. 9% versus 16. 7%). Between baseline and 6 months, significant reductions were observed in body weight [-2. 22 kg (95% CI -2. 79 to -1. 65)], blood pressure, fasting glycaemia, haemoglobin A1c [-0. 36% (95% CI -0. 51 to -0. 21)], serum uric acid [-0. 44 mg/dl (95% CI -0. 60 to -0. 28)] and urinary protein:creatinine ratio, while serum magnesium [+0. 15 mg/dl (95% CI 0. 11-0. 18)] and haemoglobin levels rose [+0. 44 g/dl (95% CI 0. 28-0. 58]. These outcomes persisted in participants followed over 12 months of treatment. SGLT2is in kidney transplant offer benefits in terms of controlling glycaemia, weight, blood pressure, anaemia, proteinuria and serum uric acid and magnesium. UTI was the most frequent adverse effect. According to our findings, these agents should be prescribed with caution in female DKTRs and those with a history of UTI.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	SGLT2 inhibitors ; Post-transplant diabetes mellitus ; Type 2 diabetes
Publicat a:	Clinical Kidney Journal, Vol. 16 Núm. 6 (january 2023) , p. 1022-1034, ISSN 2048-8513

DOI: 10.1093/ckj/sfad007
PMID: 37260993

13 p, 1.0 MB

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