Sp770sodium/Glucose Cotransporter 2 Inhibotor for the Treatment of Diabetes in Kidney Transplant Patients

Kong, Jin Min; Jeong, Joon; Chul, Yoon Seong; Whang, Eun; Kwon, Hyuk Ju; Hyun, Son Sung

doi:10.1093/ndt/gfz103.sp770

Cited by 15 publications

(34 citation statements)

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“…In terms of the quality assessment, seven studies [ 43 , 50 , 51 , 52 , 53 , 54 , 55 ] were graded as good and only one study [ 56 ] was graded as fair. There were no poor-quality studies.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of SGLT-2 Inhibitors for Treatment of Diabetes Mellitus among Kidney Transplant Patients: A Systematic Review and Meta-Analysis

et al. 2020

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Background: The objective of this systematic review was to evaluate the efficacy and safety profiles of sodium-glucose co-transporter 2 (SGLT-2) inhibitors for treatment of diabetes mellitus (DM) among kidney transplant patients. Methods: We conducted electronic searches in Medline, Embase, Scopus, and Cochrane databases from inception through April 2020 to identify studies that investigated the efficacy and safety of SGLT-2 inhibitors in kidney transplant patients with DM. Study results were pooled and analyzed utilizing random-effects model. Results: Eight studies with 132 patients (baseline estimated glomerular filtration rate (eGFR) of 64.5 ± 19.9 mL/min/1.73 m2) treated with SGLT-2 inhibitors were included in our meta-analysis. SGLT-2 inhibitors demonstrated significantly lower hemoglobin A1c (HbA1c) (WMD = −0.56% [95%CI: −0.97, −0.16]; p = 0.007) and body weight (WMD = −2.16 kg [95%CI: −3.08, −1.24]; p < 0.001) at end of study compared to baseline level. There were no significant changes in eGFR, serum creatinine, urine protein creatinine ratio, and blood pressure. By subgroup analysis, empagliflozin demonstrated a significant reduction in body mass index (BMI) and body weight. Canagliflozin revealed a significant decrease in HbA1C and systolic blood pressure. In terms of safety profiles, fourteen patients had urinary tract infection. Only one had genital mycosis, one had acute kidney injury, and one had cellulitis. There were no reported cases of euglycemic ketoacidosis or acute rejection during the treatment. Conclusion: Among kidney transplant patients with excellent kidney function, SGLT-2 inhibitors for treatment of DM are effective in lowering HbA1C, reducing body weight, and preserving kidney function without reporting of serious adverse events, including euglycemic ketoacidosis and acute rejection.

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Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of SGLT-2 Inhibitors for Treatment of Diabetes Mellitus among Kidney Transplant Patients: A Systematic Review and Meta-Analysis

et al. 2020

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“…28 Among the 11 studies, the largest reduction in mean HbA1c level (À1.93%) was observed in the study with the highest mean baseline HbA1c level (9.34%). 10 Kong et al reported a reduction in mean HbA1c level (À0.5%) after 3 months of treatment, while Halden et al, 12 Shah et al, 14 and Kong et al 17 reported reductions in mean HbA1c level of À0.2%; À0.9%; and À0.4%, respectively within 6 months. 12,14,17 The largest reductions in mean HbA1c levels were observed at the end of 12 months in all studies.…”

Section: Effect Of Sglt2i On Glycemic Control In Kt Patientsmentioning

confidence: 99%

“…10 Kong et al reported a reduction in mean HbA1c level (À0.5%) after 3 months of treatment, while Halden et al, 12 Shah et al, 14 and Kong et al 17 reported reductions in mean HbA1c level of À0.2%; À0.9%; and À0.4%, respectively within 6 months. 12,14,17 The largest reductions in mean HbA1c levels were observed at the end of 12 months in all studies. Differences in dose, baseline HbA1c and eGFR levels, study design and size could explain the observed differences between various SGLT2i.…”

Section: Effect Of Sglt2i On Glycemic Control In Kt Patientsmentioning

confidence: 99%

“…Published experience with SGLT2i in KT patients consists of 9 manuscripts and 2 abstracts including 214 patients [8][9][10][11][12][13][14][15][16][17][18] (Table 1). Study protocols and population characteristics were markedly different, making comparisons between studies difficult.…”

Section: Experience With Sglt2 Inhibition In Ktmentioning

confidence: 99%

“…6,7 In this review, we first provide an overview of SGLT2i for non-KT indications and then discuss potential beneficial effects and the safety profile of SGLT2i in KT patients with DM, by examining data from the current literature. [8][9][10][11][12][13][14][15][16][17][18] 2 | SGLT2 AND SGLT2 INHIBITION SGLT2 in kidney proximal tubular cells reabsorbs almost 90% of glucose from the glomerular filtrate. 19 SGLT2i induce glycosuria by blocking glucose reabsorption and thus, decrease hyperglycaemia in an insulin-independent manner.…”

Section: Introductionmentioning

confidence: 99%

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Sodium‐glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation: Review of the current evidence

et al. 2021

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Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are promising drugs to treat chronic kidney disease patients with or without diabetes mellitus (DM). Besides improving glycemic control, SGLT2i are cardioprotective and kidney protective and decrease bodyweight, serum uric acid, blood pressure, albuminuria and glomerular hyperfiltration. These effects may benefit graft function and survival in kidney transplant (KT) patients. In this review, we evaluate data on the efficacy and safety of SGLT2i for KT patients with DM. Eleven studies with 214 diabetic KT patients treated with SGLT2i have been reported. SGLT2i lowered haemoglobin A1c and bodyweight. While glomerular filtration rate may be reduced in the short-term, it remained similar to baseline after 3-12 months. In two studies, blood pressure decreased and remained unchanged in the others. There were no significant changes in urine protein to creatinine ratio. Regarding safety, 23 patients had urinary tract infections, 2 patients had a genital yeast infection, one had acute kidney injury, and one had mild hypoglycaemia. No cases of ketoacidosis or acute rejection were reported. In conclusion, the limited experience so far suggests that SGLT2i are safe in KT patients with DM, decrease bodyweight and improve glycemic control. However, some of the benefits observed in larger studies in the non-KT population have yet to be demonstrated in KT recipients, including preservation of kidney function, reduction in blood pressure and decreased proteinuria.

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Incretin based therapies and SGLT-2 inhibitors in kidney transplant recipients with diabetes: A systematic review and meta-analysis

Oikonomaki

Dounousi

Duni

et al. 2021

Diabetes Research and Clinical Practice

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Sp770sodium/Glucose Cotransporter 2 Inhibotor for the Treatment of Diabetes in Kidney Transplant Patients

Cited by 15 publications

References 0 publications

Efficacy and Safety of SGLT-2 Inhibitors for Treatment of Diabetes Mellitus among Kidney Transplant Patients: A Systematic Review and Meta-Analysis

Efficacy and Safety of SGLT-2 Inhibitors for Treatment of Diabetes Mellitus among Kidney Transplant Patients: A Systematic Review and Meta-Analysis

Sodium‐glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation: Review of the current evidence

Incretin based therapies and SGLT-2 inhibitors in kidney transplant recipients with diabetes: A systematic review and meta-analysis

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