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Sodium glucose cotransporter 2 inhibitors are associated with renal stabilization in heart transplantation

Lisa M Raven1,2,3, Jerry R Greenfield1,2,3, Andrew Jabbour3,4,5

  • 1Department of Diabetes and Endocrinology, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, Australia.

JHLT Open
|April 18, 2025
PubMed

Insights

Sodium glucose cotransporter 2 inhibitors (SGLT2i) may preserve kidney function in heart transplant recipients with diabetes. This study found stable estimated glomerular filtration rate in SGLT2i users versus a decline in non-users.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Heart transplant (HTx) recipients face elevated risks for type 2 diabetes mellitus and chronic kidney disease (CKD).
  • Both diabetes and CKD are independent risk factors for increased mortality in HTx patients.
  • Sodium glucose cotransporter 2 inhibitors (SGLT2i) are established treatments for diabetes, heart failure, and CKD.

Purpose of the Study:

  • To evaluate the impact of SGLT2 inhibitors on renal function in heart transplant recipients with diabetes.
  • To assess the association between SGLT2 inhibitor use and renal function changes post-heart transplantation.

Main Methods:

  • Retrospective analysis of 104 heart transplant recipients diagnosed with diabetes.
  • Comparison of renal function (estimated glomerular filtration rate) at 3 years post-transplant between SGLT2 inhibitor users (n=23) and non-users (n=81).
  • Survival analysis adjusted for diabetes type and baseline creatinine.

Main Results:

  • SGLT2 inhibitor treatment was associated with stable renal function (median eGFR change: 0 ml/min/1.73 m²).
  • Patients not exposed to SGLT2 inhibitors showed a significant decline in renal function (median eGFR change: -15 ml/min/1.73 m²; p=0.02).
  • No significant difference in survival was observed based on SGLT2 inhibitor exposure (adjusted HR 0.34, p=0.06).

Conclusions:

  • SGLT2 inhibitors may help preserve renal function in heart transplant recipients with diabetes.
  • Further prospective studies are warranted to confirm these findings and explore renal outcomes.
  • Investigating SGLT2i's role in managing comorbidities in HTx recipients is crucial.

Keywords:
SGLT2heart transplantkidneyrenalsodium glucose cotransporter 2transplantation

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