Key Points
• Source: BMC Nephrology
• Conclusion: “Empagliflozin showed some positive effects in 4 cases with better renal function than CKD [chronic kidney disease] stage 4. Further studies will be required to clarify the efficacy and safety of SGLT2 inhibitors in a larger group of patients with similar medical conditions.”
• In the current case series, Japanese researchers documented 5 renal transplant recipients with chronic kidney disease G3a-4 and metabolic syndrome who were given empagliflozin. This SGLT2 inhibitor improved clinical outcomes in 4 cases but failed in one patient with an initial estimated glomerular filtration rate (eGFR) of less than 30 ml/min/ m2.
• No significant reductions in eGFR before or after empagliflozin administration were noted. No instances of dehydration or urogenital infections occurred.
• The researchers cited the only randomized clinical trial of SGTL2-inhibitor treatment, which was performed with 22 post-transplant diabetes patients treated with empagliflozin vs. 22 placebo-treated patents. Those patients receiving empagliflozin exhibited relative decreases in HbA1c, uric acid, and body weight reduction vs. the control group. Notably, there was no change in eGFR before or after SGLT2 inhibitor treatment in the experimental group.
• “The number of cases in the literature so far is small, ranging from 8 to 22, and we believe that RCTs with a larger number of patients are needed to determine the efficacy and safety of SGLT2 inhibitors in KTR [kidney-transplant recipients],” wrote the authors. “Our case series is also small, only five cases, but there are still very few reports worldwide, and we hope that this presentation will trigger further research.”