Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Use of SGLT2 Inhibitors and GLP-1 Receptor Agonists After Kidney Transplantation

Use of SGLT2 Inhibitors and GLP-1 Receptor Agonists After Kidney Transplantation

Video Transcription

Video Summary

Dr. Mary Moss-Chendron reviews post-transplant use of GLP-1 receptor agonists and SGLT2 inhibitors to address overlapping risks in kidney transplant recipients: diabetes, cardiovascular disease, weight gain, and long-term kidney dysfunction. Diabetes is common (about half have preexisting type 2 diabetes; up to 20% develop it in the first year). Although landmark trials excluded transplant patients, emerging evidence from small studies and a meta-analysis (32 studies, >7,800 recipients) shows these agents lower A1C, promote weight loss, and are associated with reduced mortality and improved composite cardiovascular and kidney outcomes, with stable eGFR and proteinuria overall. SGLT2 inhibitors may improve magnesium and uric acid; an expected early eGFR “dip” can occur. Safety signals for UTIs or pancreatitis were not increased, though many studies excluded patients with prior UTIs. Practical use emphasizes selecting stable patients (renal function, hydration/nutrition, GI tolerance), considering infection history and hypoglycemia risk, and timing—often ≥1 year post-transplant, but sometimes as early as 1–3 months in stable cases.

Asset Subtitle

Mary Moss Chandran

Meta Tag

Module TRX

Speaker Mary Moss Chandran

Keywords

kidney transplant recipients

GLP-1 receptor agonists

SGLT2 inhibitors

post-transplant diabetes management

cardiovascular and renal outcomes