Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients
Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve cardiovascular prognosis in patients with chronic kidney disease (CKD), diabetes, and heart failure; and slow the decline of kidney dysfunction in patients with albuminuria. Although safety and efficacy of SGLT2i have not been...
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Elsevier
2025-03-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924020552 |
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| author | Lucie Maigret Lucile Basle Valérie Chatelet Laure Ecotiere Peggy Perrin Léonard Golbin Dominique Bertrand Dany Anglicheau Coralie Poulain Cyril Garrouste Clément Danthu Charlotte Boud'hors Yannick Le Meur Manon Dekeyser Fabien Duthe Bénédicte Sautenet Pierre-Guillaume Deliège Philippe Gatault |
| author_facet | Lucie Maigret Lucile Basle Valérie Chatelet Laure Ecotiere Peggy Perrin Léonard Golbin Dominique Bertrand Dany Anglicheau Coralie Poulain Cyril Garrouste Clément Danthu Charlotte Boud'hors Yannick Le Meur Manon Dekeyser Fabien Duthe Bénédicte Sautenet Pierre-Guillaume Deliège Philippe Gatault |
| author_sort | Lucie Maigret |
| collection | DOAJ |
| description | Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve cardiovascular prognosis in patients with chronic kidney disease (CKD), diabetes, and heart failure; and slow the decline of kidney dysfunction in patients with albuminuria. Although safety and efficacy of SGLT2i have not been investigated in kidney transplant recipients (KTRs), their marketing authorization leaves the possibility of their use in these patients in France. Methods: This was a prospective multicenter real-life study including all consecutive KTRs treated with SGLT2i. Results: We identified 347 KTRs treated with SGLT2i (97% with dapagliflozin), with an initiation of treatment most often beyond the first year after transplantation (87%). Importantly, 226 (65.1%) were diabetic and 245 (70.6%) were treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). We found a low incidence of urinary tract infections (UTIs) (6.6%) and genital mycosis (0.6%), without any serious adverse event. Overall, SGLT2i were stopped in 54 patients (15.6%). The causes of SGLT2i discontinuations were very diverse. The main causes were graft dysfunction (32%), intercurrent infections (17%), urinary infections (11%), and digestive symptoms (9%). KTRs with a low estimated glomerular filtration rate (eGFR), especially those with eGFR < 30 ml/min per 1.73 m2, presented with the highest incidence of SGLT2i discontinuation (P = 0.003). SGLT2i were associated with a reduction in proteinuria, found in both diabetic and nondiabetic KTRs. In addition, they had an antihypertensive effect restricted to uncontrolled-hypertensive patients. Conclusion: SGLT2i have been used in KTRs since their authorization in France. They were discontinued more frequently in patients with impaired graft function; however, the expected side effects were infrequent and not life-threatening. The short-term antiproteinuric and antihypertensive effects are promising. |
| format | Article |
| id | doaj-art-c0eb11aeb1bf44beaaeab1adb4fe029d |
| institution | OA Journals |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-c0eb11aeb1bf44beaaeab1adb4fe029d2025-08-20T02:33:40ZengElsevierKidney International Reports2468-02492025-03-0110381682710.1016/j.ekir.2024.11.033Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant RecipientsLucie Maigret0Lucile Basle1Valérie Chatelet2Laure Ecotiere3Peggy Perrin4Léonard Golbin5Dominique Bertrand6Dany Anglicheau7Coralie Poulain8Cyril Garrouste9Clément Danthu10Charlotte Boud'hors11Yannick Le Meur12Manon Dekeyser13Fabien Duthe14Bénédicte Sautenet15Pierre-Guillaume Deliège16Philippe Gatault17Service de Néphrologie-Hypertension artérielle, Dialyses, Transplantation rénale, CHRU de Tours, Tours, FranceService de Néphrologie, Dialyse et Transplantation, CHU de Reims, Reims, FranceService de Néphrologie et Transplantation Rénale, CHU de Caen, Caen, FranceService de Néphrologie et Transplantation Rénale, CHU de Poitiers, Poitiers, FranceService de Néphrologie, Dialyse et Transplantation, CHU de Strasbourg, Strasbourg, FranceService de Néphrologie et Transplantation Rénale, CHU de Rennes, Rennes, FranceService de Néphrologie et Transplantation Rénale, CHU de Rouen, Rouen, FranceDépartement de Néphrologie et transplantation rénale, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, FranceService de Néphrologie et Transplantation Rénale, CHU d’Amiens, Amiens, FranceService de Néphrologie et Transplantation Rénale, CHU de Clermont-Ferrand, Clermont-Ferrand, FranceService de Néphrologie et Transplantation Rénale, CHU de Limoges, Limoges, FranceService de Néphrologie et Transplantation Rénale, CHU d’Angers, Angers, FranceService de Néphrologie et Transplantation Rénale, CHU de Brest, Brest, FranceService de Néphrologie, CHU d’Orléans, Orléans, FranceService de Néphrologie et Transplantation Rénale, CHU de Poitiers, Poitiers, FranceService de Néphrologie-Hypertension artérielle, Dialyses, Transplantation rénale, CHRU de Tours, Tours, FranceService de Néphrologie, Dialyse et Transplantation, CHU de Reims, Reims, FranceService de Néphrologie-Hypertension artérielle, Dialyses, Transplantation rénale, CHRU de Tours, Tours, France; Unité INSERM UMR 1327 ISCHEMIA, Tours, France; Correspondence: Philippe Gatault, Service de Néphrologie-Hypertension artérielle, Dialyses, Transplantation rénale, CHRU Bretonneau, 2 Bd Tonnellé, 37044 Tours cedex 9, France.Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve cardiovascular prognosis in patients with chronic kidney disease (CKD), diabetes, and heart failure; and slow the decline of kidney dysfunction in patients with albuminuria. Although safety and efficacy of SGLT2i have not been investigated in kidney transplant recipients (KTRs), their marketing authorization leaves the possibility of their use in these patients in France. Methods: This was a prospective multicenter real-life study including all consecutive KTRs treated with SGLT2i. Results: We identified 347 KTRs treated with SGLT2i (97% with dapagliflozin), with an initiation of treatment most often beyond the first year after transplantation (87%). Importantly, 226 (65.1%) were diabetic and 245 (70.6%) were treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). We found a low incidence of urinary tract infections (UTIs) (6.6%) and genital mycosis (0.6%), without any serious adverse event. Overall, SGLT2i were stopped in 54 patients (15.6%). The causes of SGLT2i discontinuations were very diverse. The main causes were graft dysfunction (32%), intercurrent infections (17%), urinary infections (11%), and digestive symptoms (9%). KTRs with a low estimated glomerular filtration rate (eGFR), especially those with eGFR < 30 ml/min per 1.73 m2, presented with the highest incidence of SGLT2i discontinuation (P = 0.003). SGLT2i were associated with a reduction in proteinuria, found in both diabetic and nondiabetic KTRs. In addition, they had an antihypertensive effect restricted to uncontrolled-hypertensive patients. Conclusion: SGLT2i have been used in KTRs since their authorization in France. They were discontinued more frequently in patients with impaired graft function; however, the expected side effects were infrequent and not life-threatening. The short-term antiproteinuric and antihypertensive effects are promising.http://www.sciencedirect.com/science/article/pii/S2468024924020552proteinuriarenal transplantationsodium-glucose cotransporters-2 inhibitors |
| spellingShingle | Lucie Maigret Lucile Basle Valérie Chatelet Laure Ecotiere Peggy Perrin Léonard Golbin Dominique Bertrand Dany Anglicheau Coralie Poulain Cyril Garrouste Clément Danthu Charlotte Boud'hors Yannick Le Meur Manon Dekeyser Fabien Duthe Bénédicte Sautenet Pierre-Guillaume Deliège Philippe Gatault Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients Kidney International Reports proteinuria renal transplantation sodium-glucose cotransporters-2 inhibitors |
| title | Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients |
| title_full | Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients |
| title_fullStr | Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients |
| title_full_unstemmed | Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients |
| title_short | Sodium-Glucose Cotransporter-2 Inhibitor in Diabetic and Nondiabetic Renal Transplant Recipients |
| title_sort | sodium glucose cotransporter 2 inhibitor in diabetic and nondiabetic renal transplant recipients |
| topic | proteinuria renal transplantation sodium-glucose cotransporters-2 inhibitors |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924020552 |
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