Two Japanese patients with stage G3b chronic kidney disease and impaired glucose metabolism after renal transplantation
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(2020) 6:55
CASE REPORT
Open Access
Two Japanese patients with stage G3b chronic kidney disease and impaired glucose metabolism after renal transplantation successfully treated with empagliflozin Ryoichi Miyazaki*, Kyoko Miyagi and Misaki Yoshida
Abstract Background: Renal transplant recipients with chronic kidney disease (CKD) often develop abnormal glucose metabolism. Although recent studies have reported the protective effects of sodium-glucose transport protein 2 (SGLT2) inhibitors on the heart and kidneys, few have assessed their effect in renal transplant patients. Moreover, to our knowledge, there have been no studies on the effects of SGLT2 inhibitors in renal transplant recipients in Japan. Case presentation: Case 1 was a 67-year-old male renal transplant recipient with post-transplant diabetes mellitus. He was administered empagliflozin 10 mg once a day for 9 months. Over time, his HbA1c levels decreased from 6.8 to 6.0%. Case 2 was a 56-year-old male renal transplant recipient with fatty liver disease. He was administered empagliflozin 10 mg once a day for 9 months. His ALT, γ-GTP, and LDL-cholesterol levels all decreased. In both patients, body weight and the urine albumin to creatinine ratio (UACR) decreased after empagliflozin administration, but there were no changes in the estimated glomerular filtration rate. No adverse events occurred in either case. Conclusions: Administration of empagliflozin had favorable outcomes in two patients with stage G3b CKD and abnormal glucose metabolism after renal transplantation. Further studies will be required to clarify the efficacy and safety of SGLT2 inhibitors in a larger population of patients with similar medical conditions. Keywords: Renal transplant recipient, Empagliflozin, Stage G3b chronic kidney disease
Background The protective effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of antidiabetic agents, on the heart and kidneys were recently revealed in three largescale clinical trials, the EMPA-REG Outcome [1], CANV AS [2], and DECLARE-TIMI 58 [3] trials. Similarly, the CREDENCE trial [4] also showed that renal outcomes were significantly improved with SGLT2 inhibitors, * Correspondence: [email protected] Department of Internal Medicine, Fujita Memorial Hospital, 4-15-7, Fukui, Fukui 910-00004, Japan
while the DAPA-HF study [5] showed that the SGLT2 inhibitor dapagliflozin was effective in patients with heart failure with decreased left ventricular ejection fraction, with or without type 2 diabetes. Most patients who receive kidney transplantation have chronic kidney disease (CKD) [6]. After renal transplantation, the rapid improvement in nutrition may result in overnutrition. This overnutrition in addition to the steroids and other immunosuppressants administered after kidney transplantation can lead to abnormal glucose metabolism in some patients [7]. Little is currently known about the utility of
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, whi
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