Expanding the Therapeutic Landscape: Sodium-Glucose Co-transporter 2 Inhibitors in Kidney Transplant Recipients
Abstract
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are well-established oral antidiabetic agents, which also have an important role in slowing the progression of chronic kidney disease and providing cardiovascular protection, particularly in patients with heart failure. The use of SGLT2i in renal transplant recipients is of growing clinical interest; however, the majority of supporting evidence highlighting their efficacy and safety in this population comes from small, retrospective observational studies rather than large randomized trials. This review synthesizes current evidence on the efficacy and safety of SGLT2i in renal transplant recipients, including both diabetic and non-diabetic individuals. Literature search was carried out on multiple databases using a combination of both keywords and free-text search. There is strong evidence from several studies to support a beneficial role of SGLT2i in diabetic renal transplant patients in terms of improving glycaemic control, reducing proteinuria, preserving renal allograft function, and in reducing the risk of major adverse cardiovascular and renal effects and mortality in transplant recipients. There is encouraging but insufficient evidence to support the routine use of SGLT2i in non-diabetic renal transplant recipients, and there is a significant literature gap regarding transplant patients with impaired renal function. SGLT2i appear to have a good safety profile with the predominant side effect being urinary tract…
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