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Updated: May 20, 2025
Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique
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Are There Any Renoprotective Effects of SGLT2 Inhibitors in Heart Transplant Recipients with Diabetes?
You-Min Lu1, Chih-Ying Chang1, Mei-Fei Chen1
1Division of Pharmacy.
Background:
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown renoprotective effects in diabetic patients, however their impact on heart transplant recipients remains controversial due to limited data.
Methods:
This retrospective cohort study included heart transplant recipients with diabetes from January 2016 to December 2023. The patients were divided into a treatment group who used SGLT2 inhibitors for at least 1 year, and a control group who had never used SGLT2 inhibitors. We used propensity score matching to balance baseline characteristics between the two groups. The primary outcome was a renal-specific composite, including a sustained decline of ≥ 50% in estimated glomerular filtration rate (eGFR), end-stage kidney disease, or death from renal causes.
Results:
After 15-18 months, the SGLT2 inhibitor group showed significant improvements in eGFR compared to the control group. The renal-specific composite outcome occurred less frequently in the SGLT2 inhibitor group compared with the control group (log-rank test, p = 0.0064). The SGLT2 inhibitor group had a lower risk of the renal-specific composite outcome compared to the control group, and this finding was consistent across the study cohort [adjusted hazard ratio (aHR): 0.30; p = 0.0270] and propensity-matched cohort (aHR: 0.26; p = 0.0341).
Conclusions:
The long-term use of SGLT2 inhibitors in heart transplant recipients with diabetes mellitus was associated with significant renal function preservation and reduced risk of adverse renal outcomes. These findings support the renoprotective potential of SGLT2 inhibitors in this population, warranting further prospective studies.
Insights
Sodium-glucose cotransporter-2 (SGLT2) inhibitors preserve kidney function in heart transplant recipients with diabetes. Long-term use reduced adverse renal outcomes, suggesting significant renoprotective potential.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Sodium-glucose cotransporter-2 (SGLT2) inhibitors demonstrate renoprotective effects in diabetic patients.
- Their impact on heart transplant recipients is not well-established due to limited data.
Purpose of the Study:
- To evaluate the long-term renoprotective effects of SGLT2 inhibitors in heart transplant recipients with diabetes mellitus.
- To assess the impact of SGLT2 inhibitors on renal function and adverse renal outcomes in this specific patient population.
Main Methods:
- Retrospective cohort study of heart transplant recipients with diabetes (2016-2023).
- Comparison between patients using SGLT2 inhibitors for ≥1 year and a control group.
- Propensity score matching was employed to balance baseline characteristics.
- Primary outcome: renal-specific composite (≥50% eGFR decline, ESKD, or renal death).
Main Results:
- SGLT2 inhibitor use was associated with significant eGFR improvements over 15-18 months.
- The incidence of the renal-specific composite outcome was significantly lower in the SGLT2 inhibitor group (p=0.0064).
- Adjusted hazard ratios indicated a reduced risk of adverse renal outcomes (aHR: 0.30; p=0.0270 in cohort, aHR: 0.26; p=0.0341 in matched cohort).
Conclusions:
- Long-term SGLT2 inhibitor use preserves renal function in heart transplant recipients with diabetes.
- SGLT2 inhibitors significantly reduce the risk of adverse renal outcomes in this population.
- Findings support the renoprotective potential of SGLT2 inhibitors, suggesting a need for prospective studies.
