Transplant International (Jun 2024)
SGLT2 Inhibitors Correct Fluid Overload in Adult Kidney Transplant Recipients—A Prospective Observational Study
- Anja Schork,
- Anja Schork,
- Anja Schork,
- Marie-Luise Eberbach,
- Marie-Luise Eberbach,
- Marie-Luise Eberbach,
- Ferruh Artunc,
- Ferruh Artunc,
- Ferruh Artunc,
- Ferruh Artunc,
- Bernhard N. Bohnert,
- Bernhard N. Bohnert,
- Bernhard N. Bohnert,
- Felix Eisinger,
- Felix Eisinger,
- Felix Eisinger,
- David J. Heister,
- David J. Heister,
- David J. Heister,
- Dorothea Vosseler,
- Dorothea Vosseler,
- Dorothea Vosseler,
- Silvio Nadalin,
- Andreas L. Birkenfeld,
- Andreas L. Birkenfeld,
- Andreas L. Birkenfeld,
- Nils Heyne,
- Nils Heyne,
- Nils Heyne,
- Martina Guthoff,
- Martina Guthoff,
- Martina Guthoff
Affiliations
- Anja Schork
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Anja Schork
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Anja Schork
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Marie-Luise Eberbach
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Marie-Luise Eberbach
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Marie-Luise Eberbach
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Ferruh Artunc
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Ferruh Artunc
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Ferruh Artunc
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Ferruh Artunc
- Department of Cardiology and Nephrology, Sindelfingen Hospital, Sindelfingen, Germany
- Bernhard N. Bohnert
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Bernhard N. Bohnert
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Bernhard N. Bohnert
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Felix Eisinger
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Felix Eisinger
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Felix Eisinger
- German Center for Diabetes Research (DZD), Tübingen, Germany
- David J. Heister
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- David J. Heister
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- David J. Heister
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Dorothea Vosseler
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Dorothea Vosseler
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Dorothea Vosseler
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Silvio Nadalin
- Department of General and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
- Andreas L. Birkenfeld
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Andreas L. Birkenfeld
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Andreas L. Birkenfeld
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Nils Heyne
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Nils Heyne
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Nils Heyne
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Martina Guthoff
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
- Martina Guthoff
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Martina Guthoff
- German Center for Diabetes Research (DZD), Tübingen, Germany
- DOI
- https://doi.org/10.3389/ti.2024.12879
- Journal volume & issue
-
Vol. 37
Abstract
In this longitudinal observational study, we measured urinary glucose concentration, body composition and volume status (bioimpedance spectroscopy) and plasma renin and aldosterone concentrations in n = 22 kidney transplant recipients (KTRs) initiating on SGLT2I at baseline (BL), and after 1 week and 1, 3, and 6 months. Estimated glomerular filtration rate (eGFR) decreased by −2 mL/min/1.73 m2 (IQR −10–0) after 1 week and remained stable thereafter. Urinary glucose concentration was 10 (3–24) g/g creatinine after 1 week and correlated with eGFR (r2 = 0.273; p = 0.057). SGLT2I did not affect HbA1c, fasting blood glucose, body weight, fat or lean mass. SGLT2I decreased fluid overload dependent on baseline overhydration (OH, r2 = 0.54, p = 0.0003) without occurrence of dehydration. Plasma aldosterone increased at day 7, while plasma renin did not change significantly. In conclusion, SGLT2I corrected fluid overload in patients with elevated overhydration at baseline, while in euvolemic KTRs fluid status remained stable without reduction of body water below the reference range, thus promoting the safety of SGLT2I therapy in patients following kidney transplantation. Glucosuria, together with effects of SGLT2I on blood glucose control and body weight, is attenuated in KTRs dependent on eGFR.
Keywords
