Impact of Sodium‐Glucose Cotransporter‐2 Inhibitors on Proteinuria in Kidney Transplant Recipients
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| Formato: | Artículo Open Access |
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Wiley
2025
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| _version_ | 1867003391036620800 |
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| author | Emili Anderson Stephanie Shabanowitz Kinley Jessup Rachel Bassett Allen Mary Chandran Anita Yang |
| author_facet | Emili Anderson Stephanie Shabanowitz Kinley Jessup Rachel Bassett Allen Mary Chandran Anita Yang Emili Anderson Stephanie Shabanowitz Kinley Jessup Rachel Bassett Allen Mary Chandran Anita Yang |
| collection | Wiley Open Access |
| contents | Impact of Sodium‐Glucose Cotransporter‐2 Inhibitors on Proteinuria in Kidney Transplant Recipients Emili Anderson Stephanie Shabanowitz Kinley Jessup Rachel Bassett Allen Mary Chandran Anita Yang Clinical Transplantation ABSTRACT Introduction Proteinuria is a marker of kidney dysfunction and increased cardiovascular mortality. Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiorenal protection in chronic kidney disease, regardless of type 2 diabetes mellitus (T2DM) status. However, data evaluating SGLT2i impact on cardiorenal outcomes in kidney transplant recipients (KTRs) are limited. Methods This single‐center, retrospective cohort study evaluated the safety and efficacy of SGLT2i therapy in adult KTRs transplanted between January 1, 2020 and December 31, 2023. Primary outcomes were changes in urine protein‐to‐creatinine ratio (UPCR) and urine albumin‐to‐creatinine ratio (UACR) at 1‐, 3‐, 6‐, and 12‐months post‐initiation. Secondary outcomes included changes in estimated glomerular filtration rate (eGFR), BMI, and hemoglobin A1c (HbA1c). Safety outcomes were cardiovascular hospitalization, acute kidney injury, urinary tract infection, and biopsy‐proven rejection within 12 months. Results SGLT2i therapy was initiated in 77 KTRs, 524 days post‐transplant, predominantly in males (74.3%), African Americans (62.8%), and patients with T2DM (80.7%). Baseline UPCR and UACR were 0.387 g/g and 302.2 mg/g, respectively. No significant changes in UPCR, UACR, or eGFR were observed. Renal function was preserved at 12 months, with a transient decline at 1‐month that returned to baseline by 3 months. HbA1c and BMI remained stable. Few safety events occurred. Conclusions In KTRs with moderate proteinuria, SGLT2i therapy was well tolerated with stable renal function over 12 months. A transient eGFR dip is consistent with patterns seen in non‐transplant populations. Absence of significant metabolic changes may reflect well‐controlled baseline parameters. Further studies are warranted to evaluate SGLT2i benefits in KTRs, especially in patients with higher grade proteinuria or early post‐transplant initiation. 10.1111/ctr.70365 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70365 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70365 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Impact of Sodium‐Glucose Cotransporter‐2 Inhibitors on Proteinuria in Kidney Transplant Recipients Emili Anderson Stephanie Shabanowitz Kinley Jessup Rachel Bassett Allen Mary Chandran Anita Yang Clinical Transplantation Impact of Sodium‐Glucose Cotransporter‐2 Inhibitors on Proteinuria in Kidney Transplant Recipients Emili Anderson Stephanie Shabanowitz Kinley Jessup Rachel Bassett Allen Mary Chandran Anita Yang Clinical Transplantation ABSTRACT Introduction Proteinuria is a marker of kidney dysfunction and increased cardiovascular mortality. Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiorenal protection in chronic kidney disease, regardless of type 2 diabetes mellitus (T2DM) status. However, data evaluating SGLT2i impact on cardiorenal outcomes in kidney transplant recipients (KTRs) are limited. Methods This single‐center, retrospective cohort study evaluated the safety and efficacy of SGLT2i therapy in adult KTRs transplanted between January 1, 2020 and December 31, 2023. Primary outcomes were changes in urine protein‐to‐creatinine ratio (UPCR) and urine albumin‐to‐creatinine ratio (UACR) at 1‐, 3‐, 6‐, and 12‐months post‐initiation. Secondary outcomes included changes in estimated glomerular filtration rate (eGFR), BMI, and hemoglobin A1c (HbA1c). Safety outcomes were cardiovascular hospitalization, acute kidney injury, urinary tract infection, and biopsy‐proven rejection within 12 months. Results SGLT2i therapy was initiated in 77 KTRs, 524 days post‐transplant, predominantly in males (74.3%), African Americans (62.8%), and patients with T2DM (80.7%). Baseline UPCR and UACR were 0.387 g/g and 302.2 mg/g, respectively. No significant changes in UPCR, UACR, or eGFR were observed. Renal function was preserved at 12 months, with a transient decline at 1‐month that returned to baseline by 3 months. HbA1c and BMI remained stable. Few safety events occurred. Conclusions In KTRs with moderate proteinuria, SGLT2i therapy was well tolerated with stable renal function over 12 months. A transient eGFR dip is consistent with patterns seen in non‐transplant populations. Absence of significant metabolic changes may reflect well‐controlled baseline parameters. Further studies are warranted to evaluate SGLT2i benefits in KTRs, especially in patients with higher grade proteinuria or early post‐transplant initiation. 10.1111/ctr.70365 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Impact of Sodium‐Glucose Cotransporter‐2 Inhibitors on Proteinuria in Kidney Transplant Recipients |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70365 |