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The Capital Region of Denmark - a part of Copenhagen University Hospital

Sodium-Glucose Cotransporter 2 Inhibitors for Diabetes Mellitus Control After Kidney Transplantation: Review of the Current Evidence

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  1. Increased rate of force development and neuromuscular activity after high load resistance training in patients undergoing dialysis

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  2. Prevention and treatment of diabetic nephropathy with blood pressure lowering drugs

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  • Mehmet Kanbay
  • Atalay Demiray
  • Baris Afsar
  • Kagan E Karakus
  • Alberto Ortiz
  • Mads Hornum
  • Adrian Covic
  • Pantelis Sarafidis
  • Peter Rossing
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Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are promising drugs to treat chronic kidney disease patients with or without diabetes mellitus (DM). Besides improving glycemic control, SGLT2i are cardioprotective and kidney protective and decrease bodyweight, serum uric acid, blood pressure, albuminuria and glomerular hyperfiltration. These effects may benefit graft function and survival in kidney transplant (KT) patients. In this review, we evaluate data on the efficacy and safety of SGLT2i for KT patients with DM. Eleven studies with 214 diabetic KT patients treated with SGLT2i have been reported. SGLT2i lowered haemoglobin A1c and bodyweight. While glomerular filtration rate may be reduced in the short-term, it remained similar to baseline after 3-12 months. In two studies, blood pressure decreased and remained unchanged in the others. There were no significant changes in urine protein to creatinine ratio. Regarding safety, 23 patients had urinary tract infections, 2 patients had a genital yeast infection, one had acute kidney injury, and one had mild hypoglycaemia. No cases of ketoacidosis or acute rejection were reported. In conclusion, the limited experience so far suggests that SGLT2i are safe in KT patients with DM, decrease bodyweight and improve glycemic control. However, some of the benefits observed in larger studies in the non-KT population have yet to be demonstrated in KT recipients, including preservation of kidney function, reduction in blood pressure and decreased proteinuria.

Original languageEnglish
Issue number12
Pages (from-to)1007-1017
Number of pages11
Publication statusPublished - Dec 2021

    Research areas

  • chronic kidney disease, diabetic kidney disease, kidney transplant, post-transplant diabetes mellitus, SGLT2 inhibitors, transplantation

ID: 66943096