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The Efficacy and Safety of SGLT2 Inhibitors in Diabetes Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

Boonpiraks K, Krisanapan P, Anumas S, Thongprayoon C, Cheungpasitporn W, Pattharanitima P

F1000Research, 2025

2,713 participants · 6 citations

Abstract

Background: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have shown cardiorenal benefits in the general population; however, evidence regarding their efficacy and safety in kidney transplant recipients (KTRs) remains sparse. This meta-analysis seeks to evaluate the therapeutic efficacy and safety profile of SGLT-2 inhibitors specifically in the diabetes KTR population.

Methods: We conducted a systemic review and meta-analysis following a registered protocol in the PROSPERO (CRD42023404886). A comprehensive literature search was performed using PubMed, Cochrane, and Scopus databases up to October 23 th, 2024. We included observational and clinical trials which compared SGLT-2 inhibitors with control groups in KTRs. Risk of bias was evaluated by funnel plot. We reported differences in treatment effects as risk ratios (RRs) or weighted mean difference (WMD) with 95% confidence intervals (CIs).

Results: A total of seven studies comprising 2,713 patients were included in this analysis. SGLT-2 inhibitors were associated with a significant reduction in HbA1c levels (WMD -0.37%; 95% CI -0.73 to -0.01; p = 0.04) and BMI (WMD -0.89 kg/m 2; 95% CI -1.27 to -0.50; p < 0.001). Additionally, SGLT-2 inhibitors demonstrated a beneficial effect in reducing mortality (RR 0.25; 95% CI 0.06 to 0.98; p = 0.05) and cardiovascular disease (CVD) (RR 0.41; 95% CI 0.17 to 0.98; p = 0.04). However, SGLT-2 inhibitors did not demonstrate benefit in kidney-related outcomes. Importantly, there was…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,713 participants or records.

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