Use of Empagliflozin in Recipients of Kidney Transplant: A Report of 8 Cases
Abstract
Transplant teams face increasing challenges to manage diabetes following kidney transplantation. There is an increasing number of diabetics undergoing transplantation and there is an increased incidence of posttransplant diabetes mellitus (PTDM) due to a higher prevalence of obesity, increased use of steroids and calcineurin inhibitors, and the acceptance of older patients as potential candidates. The options for treating diabetes in the general population are expanding. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors is one of the new modalities of treatment. We report the cases of 8 patients who underwent kidney transplantation and were treated with the SGLT-2 inhibitor empagliflozin for their pre-existing diabetes or for the development of PTDM. They were followed for an average of 12 months. The average age of the patients was 42.5 years. All 8 patients were taking tacrolimus, mycophenolate, and prednisolone. Although creatinine increased slightly (from 88.5 mmol/L to 99.5 mmol/L) in the month after starting empagliflozin, it stabilized after that. Hemoglobin A 1c decreased on average 0.85 g/dL. Urine protein decreased by 0.6 g per day and weight decreased on average 2.4 kg throughout the year. One patient discontinued the medication due to recurrent urinary tract infections.
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For T2D and posttransplant diabetes, it is reasonable to treat kidney transplant recipients with metformin according to eGFR, as for the broader population with T2D, because risks of metformin are related to kidney function.
“For T2D and posttransplant diabetes, it is reasonable to treat kidney transplant recipients with metformin according to eGFR, as for the broader population with T2D, because risks of metformin are related to kidney function (80–84).”
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- Authors
- Attallah, N., & Yassine, L.
- Affiliations
- Cleveland Clinic Abu Dhabi (AE)
- Imperial College London Diabetes Centre (AE)
- Corresponding author
- Attallah, Nizar
- ORCID
- Attallah, Nizar
- Venue
- Transplantation Proceedings
- Publisher
- Elsevier BV
- Published
- 2019-12
- Volume
- 51
- Issue
- 10
- Pages
- 3275-3280
- ISSN
- 0041-1345 (ISSN-L)
- OpenAlex
- W2983783768
- Cited by
- 62
- References
- 37
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 12 · 2023: 12 · 2022: 9 · 2021: 12 · 2020: 4
- FWCI
- 5.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Transplantation Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- empagliflozin, kidney transplantation, post-transplant diabetes mellitus, SGLT2 inhibitors, diabetes management, tacrolimus, immunosuppressive therapy, glycemic control, urinary tract infection, weight loss, proteinuria
- MeSH terms
- Sodium-Glucose Transporter 2 Inhibitors, Adult, Benzhydryl Compounds, Diabetes Mellitus, Female, Glucosides, Glycated Hemoglobin, Humans, Immunosuppressive Agents, Male, Middle Aged, Postoperative Complications, Risk Factors, Kidney Transplantation, Tacrolimus, Treatment Outcome, Calcineurin Inhibitors
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