Kidney Week

Abstract: SA-OR89

Effects of Empagliflozin on Proteinuria in Kidney Transplant Recipients: Preliminary Data of a Randomized Control Trial

Session Information

• Transplantation: Clinical Management and Monitoring
  October 26, 2024 | Location: Room 25, Convention Center
  Abstract Time: 05:40 PM - 05:50 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Rakpithayanon, Chanyanuch, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Chanyanuch Rakpithayanon, MD

• Wuttiputhanun, Thunyatorn, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Thunyatorn Wuttiputhanun

• Udomkarnjananun, Suwasin, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Suwasin Udomkarnjananun, MD

• Praditpornsilpa, Kearkiat, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Kearkiat Praditpornsilpa, MD

• Avihingsanon, Yingyos, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Yingyos Avihingsanon, MD

• Townamchai, Natavudh, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Natavudh Townamchai, MD

Background

Post-kidney transplant proteinuria poses a substantial risk of cardiovascular events, graft loss, and mortality. Although evidence suggests the potential efficacy of empagliflozin in proteinuria reduction, a definitive comprehension of its therapeutic and safety profile in kidney transplant recipients (KTRs) remains elusive.

Methods

This preliminary double-blinded, randomized controlled trial systematically investigated the impact of empagliflozin on proteinuria in KTRs in comparison to a placebo. The inclusion criteria were stable graft function and the absence of rejection or alterations in immunosuppressive regimens within the preceding 3 months. Participants in the intervention arm were administered empagliflozin at a daily dosage of 10 mg for 3 months. The primary outcome measures included the mean differences in proteinuria, while secondary outcomes encompassed estimated glomerular filtration rate (eGFR), metabolic parameters such as blood sugar, blood pressure, and body weight.

Results

A total of 41 KTRs underwent enrollment and randomization, with both intervention and control groups exhibiting comparable baseline characteristics, including age, gender, underlying renal disease, history of rejection, and chronic calcineurin inhibitor toxicity. The intervention group demonstrated a significant proteinuria reduction with mean UPCI difference of -726.01 mg/gCr (95% CI -1426.62 to -25.41, P=0.043). The eGFR displayed no statistically significant difference (mean difference -1.82 ml/min/1.73m2, 95% CI -5.81 to 2.17, P=0.361). Evaluation of potential adverse effects, including urogenital infections, or metabolic acidosis, revealed no significant distinctions between groups.

Conclusion

Despite being underpowered by sample size, this study still demonstrates a statistically significant reduction in proteinuria with empagliflozin among kidney transplant recipients. The observed trend suggests a potential therapeutic benefit. Furthermore, the absence of notable side effects underscores the favorable safety profile of empagliflozin in this patient population.