ABSTRACT
Objetives:
The incidence of posttransplant diabetes and the elevated cardiovascular (CV) risk among transplant recipients are on the rise. Glucagon-like peptide agonists have the potential to mitigate the effects of immunosuppressive drugs, addressing both hyperglycemia and weight gain. This makes them appealing for use in this population, given their CV and renoprotective benefits. Nevertheless, there is insufficient substantial evidence regarding their efficacy in diabetic kidney transplant recipients (KTR).
Methods:
The objective of this retrospective study was to assess the effectiveness and safety of glucagon-like peptide agonists in KTR. The primary focus was to evaluate their impact on various parameters, such as hemoglobin A1c levels, body mass index (BMI), lipid panel, hemoglobin levels, renal allograft function (estimated glomerular filtration rate [eGFR]), and urinary protein-to-creatinine ratio.
Results:
During a median observation period of 18 months, this investigation included 64 renal transplant patients. Median eGFR at baseline was 61.9 mL/min/1.73 m2 and remained stable throughout the follow-up. Median HbA1c decreased from 7.5 to 7% (95%CI; p < 0.002). A significant improvement in BMI and lipid panel were also observed. We did not observed significant changes regarding median creatinine and urinary protein:creatinine ratio levels. No side effects justified discontinuation of the drug.
Conclusion:
This study shows that the use of glucagon-like peptide agonists is feasible and well-tolerated in KTR, with no significant side effects observed. Subsequent studies are needed to explore whether glucagon-like peptide agonists can effectively improve allograft survival in these patients.
Descriptors
Glucagon-like Peptide-1 Receptor Agonists; Kidney Transplant; Diabetes Mellitus