TOPLINE

In a real-world setting, the use of SGLT2 inhibitors over 12 months was associated with significant reductions in BMI and systolic blood pressure (SBP) in kidney transplant recipients (KTRs) with or without diabetes, without significant changes in kidney function or proteinuria.

METHODOLOGY

• Researchers conducted a retrospective, real-world multicentre study to evaluate the effect of SGLT2 inhibitors in patients who had undergone kidney transplantation and did or did not have diabetes.
• They included 88 patients (mean age, 61.4 years; 32.9% women; 68% with diabetes) who received SGLT2 inhibitors and 88 matched control patients who did not receive SGLT2 inhibitors, all recruited from three outpatient nephrology clinics in Italy.
• SGLT2 inhibitor therapy was initiated in clinically stable KTRs at least 1 year post-transplant who had no history of recurrent urinary tract or genital infections and an estimated glomerular filtration rate (eGFR) greater than 20 mL/min/1.73 m².
• Primary endpoints were changes in BMI, SBP, eGFR, and 24-hour proteinuria.
• Patients were followed up for a maximum of 12 months after the initiation of SGLT2 inhibitors.

TAKEAWAY

• At 12 months, patients in the SGLT2 inhibitor group had a greater reduction in BMI (mean difference [MD], -1.17; P = .001) and SBP (MD, -5.83 mm Hg; P = .042) than those in the control group.
• No significant changes in the eGFR or 24-hour proteinuria were observed between the SGLT2 inhibitor and control groups.
• Urinary tract infections occurred in 17 patients in the SGLT2 inhibitor group and led to discontinuation in 13 of them. No cases of genital infections or euglycaemic ketoacidosis were observed.

IN PRACTICE

"Our findings support the use of SGLT2i [SGLT2 inhibitors] in KTR according to prescribing principles similar to those applied in CKD [chronic kidney disease]. In patients with preserved graft function, SGLT2i show favorable effects on BMI and SBP, potentially improving the overall CV [cardiovascular] risk profile," the authors wrote.

SOURCE

This study was led by Daniela Picciotto, IRCCS Ospedale Policlinico San Martino, Unit of Nephrology, Dialysis and Transplantation, Genova, Italy. It was published online on July 10, 2026, in the American Journal of Nephrology.

LIMITATIONS

The study had a short follow-up period, lacked randomisation, and did not include data on immunologic parameters or potential biomarkers. The exclusion of patients with a history of recurrent urinary tract or genital infections may have introduced selection bias. Additionally, differences in the use of renin-angiotensin-aldosterone system inhibitors between the two groups were not addressed in propensity score matching.

DISCLOSURES

This study did not receive any specific funding. The authors declared having no conflicts of interest. One author reported being a member of the journal's editorial board.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.