Early initiation of sodium-glucose linked transporter inhibitors (SGLT-2i) and associated metabolic and electrolyte outcomes in diabetic kidney transplant recipients

Endocrinol Diabetes Metab. 2020 Sep 13;4(2):e00185. doi: 10.1002/edm2.185. eCollection 2021 Apr.

Abstract

There is a paucity of data on the use of SGLT2 inhibitors on outcomes in kidney transplant recipients. There may be concern in initiating these agents, especially within the first year post-transplant when renal function is more labile and immunosuppression more intense, due to a presumed high risk of urinary infections and acute kidney injury. This is a retrospective study on 50 kidney transplant recipients, half of whom were started on therapy within the first year of transplant. Over a follow-up period of 6 months, overall patients had a statistically significant improvement in weight by -2.95 kg [SD 3.54, P = <.0001 (CI: 3.53, 1.50)] as well as hypomagnesemia 0.13 [SD 1.73, P = .0004 (CI: 0.06, 0.20)]. Overall insulin usage declined by -3.7 units [SD 22.8, P = .17]. 14% of patients had at least one urinary tract infection although this rate is not different (~20%) than that reported historically in this high-risk population.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / prevention & control
  • Adult
  • Aged
  • Diabetic Nephropathies / metabolism*
  • Diabetic Nephropathies / surgery*
  • Electrolytes / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypercalciuria / etiology
  • Hypercalciuria / prevention & control
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Nephrocalcinosis / etiology
  • Nephrocalcinosis / prevention & control
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Renal Tubular Transport, Inborn Errors / etiology
  • Renal Tubular Transport, Inborn Errors / prevention & control
  • Retrospective Studies
  • Risk
  • Sodium-Glucose Transporter 2 Inhibitors / administration & dosage*
  • Sodium-Glucose Transporter 2 Inhibitors / pharmacology*
  • Time Factors
  • Treatment Outcome
  • Weight Gain

Substances

  • Electrolytes
  • Sodium-Glucose Transporter 2 Inhibitors

Supplementary concepts

  • Hypomagnesemia primary