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Optimal use of SGLT2 inhibitors in diabetic kidney transplant recipients

Phuong-Thu T Pham1, Phuong-Chi T Pham2,3

  • 1Nephrology Division, Kidney Transplant Program David Geffen School of Medicine at University of California at Los Angeles (UCLA), Los Angeles, CA, United States.

Frontiers in Nephrology
|September 7, 2023
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) offer cardiovascular and kidney protection beyond diabetes. This review examines SGLT2i efficacy and safety in kidney transplant recipients, addressing infection concerns.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are primarily antidiabetic agents.
  • SGLT2i demonstrate cardio- and reno-protective effects in diverse populations, including those with and without type 2 diabetes mellitus.
  • Concerns regarding increased infection risk (genital mycotic and urinary tract infections) have limited SGLT2i use in transplant settings.

Purpose of the Study:

  • To comprehensively review the literature on SGLT2i efficacy and safety in diabetic kidney transplant recipients.
  • To provide expert opinion on the optimal use of SGLT2i in this specific patient population.

Main Methods:

  • Literature review of studies investigating SGLT2i in diabetic kidney transplant recipients.
  • Analysis of efficacy data (cardio- and reno-protective effects).
  • Assessment of safety data, focusing on infection risks.

Main Results:

  • Evidence suggests SGLT2i provide cardio- and reno-protective benefits in diabetic kidney transplant recipients.
  • Potential risks include increased genital mycotic and urinary tract infections, requiring careful monitoring.
  • Balancing benefits against risks is crucial for patient selection and management.

Conclusions:

  • SGLT2i may offer significant benefits for diabetic kidney transplant recipients, warranting consideration.
  • Careful patient selection and monitoring for infections are essential for safe SGLT2i implementation.
  • Further research is needed to optimize SGLT2i use in the post-transplant period.
Keywords:
PTDMSGLT2 inhibitordiabetic kidney diseasediabetic kidney transplant recipientskidney transplantationpost-transplantation diabetes mellitussodium-glucose cotransporter 2 inhibitor

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