Effects of SGLT2 Inhibitors on Proteinuria and Renal Function Parameters in Non-Diabetic Kidney Transplant...

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated significant renoprotective effects in patients with chronic kidney disease. However, kidney transplant recipients have been excluded from major randomized trials, and evidence in non-diabetic transplant patients remains limited. This study aimed to investigate the potential effects of SGLT2 inhibitors in non-diabetic kidney transplant recipients. Methods: Kidney transplant recipients were screened retrospectively and divided into two groups based on SGLT2 inhibitor use. A total of 18 non-diabetic patients receiving SGLT2 inhibitors (Group 1) were compared with 30 matched controls (Group 2). Patients were followed at baseline, 3, 6, and 12 months. Proteinuria, serum creatinine, eGFR, uric acid, and tacrolimus levels were analyzed. Results: Baseline demographic and biochemical characteristics were similar between groups. In Group 1, proteinuria decreased by 20% at 6 months and 26% at 12 months compared with baseline. The reduction in proteinuria from baseline to 6 months was significantly greater in Group 1 than in controls (p = 0.037). No significant changes were observed in serum creatinine, eGFR, tacrolimus levels, or infection-related adverse events between groups. Conclusions: SGLT2 inhibitors may confer an early antiproteinuric benefit in non-diabetic kidney transplant recipients without apparent adverse effects on renal function or safety. Larger prospective studies are needed to confirm long-term effects.