Sodium glucose cotransporter 2 inhibitors are associated with renal stabilization in heart transplantation

JHLT Open Pub Date : 2025-03-22 DOI:10.1016/j.jhlto.2025.100255

Lisa M. Raven MBBS, FRACP , Jerry R. Greenfield MBBS (Hons 1), PhD, FRACP , Andrew Jabbour BSc (Med), MBBS (Hons), PhD, FRACP , Peter S. Macdonald MBBS, MD, PhD, FRACP , Christopher A. Muir MBBS (Hons), FRACP, PhD

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Abstract

Sodium glucose cotransporter 2 inhibitors (SGLT2i) are standard of care for type 2 diabetes mellitus, heart failure, and chronic kidney disease (CKD). Heart transplant (HTx) recipients are at increased risk of diabetes and CKD, and both are independently associated with increased mortality. In a retrospective analysis of 104 HTx recipients with diabetes (23 exposed to SGLT2i, 81 not exposed), SGLT2i treatment was associated with stable renal function at 3 years post-HTx, measured by estimated glomerular filtration rate change from baseline (median change of 0 ml/min/1.73 m² (interquartile range [IQR] −13 to +11)), compared to a change of −15 ml/min/1.73 m² (IQR −27 to +1) in patients not exposed to SGLT2i (p = 0.02). There was no significant difference in survival by SGLT2i exposure, adjusted for diabetes type and baseline creatinine (hazard ratio 0.34, confidence intervals 0.11-1.06, p = 0.06). Further investigation of SGLT2i in HTx recipients, particularly focusing on renal outcomes, is required.

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钠葡萄糖共转运蛋白2抑制剂与心脏移植肾稳定有关

葡萄糖共转运蛋白2抑制剂钠（SGLT2i）是2型糖尿病、心力衰竭和慢性肾脏疾病（CKD）的标准治疗药物。心脏移植（HTx）受者患糖尿病和CKD的风险增加，两者都与死亡率增加独立相关。在一项对104例糖尿病患者（23例暴露于SGLT2i， 81例未暴露于SGLT2i）的HTx接受者的回顾性分析中，SGLT2i治疗与HTx治疗后3年肾功能稳定相关，通过估计肾小球滤过率从基线变化来测量（中位数变化为0 ml/min/1.73 m2（四分位数范围[IQR] - 13至+11）），而未暴露于SGLT2i的患者的变化为- 15 ml/min/1.73 m2 (IQR - 27至+1)（p = 0.02）。经糖尿病类型和基线肌酐校正后，SGLT2i暴露对生存率无显著差异（风险比0.34，置信区间0.11-1.06,p = 0.06）。需要进一步研究HTx受者的SGLT2i，特别是关注肾脏预后。

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JHLT Open

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