There is a paucity of data on the use of SGLT2 inhibitors on outcomes in kidney transplant recipients. There may be concern in initiating these agents, especially within the first year post‐transplant when renal function is more labile and immunosuppression more intense, due to a presumed high risk of urinary infections and acute kidney injury. This is a retrospective study on 50 kidney transplant recipients, half of whom were started on therapy within the first year of transplant. Over a follow‐up period of 6 months, overall patients had a statistically significant improvement in weight by −2.95 kg [SD 3.54, P = <.0001 (CI: 3.53, 1.50)] as well as hypomagnesemia 0.13 [SD 1.73, P = .0004 (CI: 0.06, 0.20)]. Overall insulin usage declined by −3.7 units [SD 22.8, P = .17]. 14% of patients had at least one urinary tract infection although this rate is not different (~20%) than that reported historically in this high‐risk population.
Solid organ transplant recipients endure intensive, often lymphocytedepleting immunosuppression in order to preserve their allograft function and prevent rejection. Aggressive immunosuppression in the early post-transplant period increases the risk of opportunistic infections early after transplantation. 1 Cytomegalovirus (CMV) is the most frequent infectious complication after solid organ transplantation, and it is associated with increased morbidity and mortality. 2 In the absence of antiviral prophylaxis, CMV infections occur in approximately 35% to 91% of lung and heart-lung, 20% to 74% of heart, 8% to 65% of liver, and 8% to 65% of kidney and/ or pancreas transplant recipients mostly occurring within the first 3 months after transplant when the intensity of immunosuppression
The efficacy of vaccinations among vulnerable populations such as solid organ transplant recipients on chronic immunosuppression have been suboptimal compared to the general population
1‐2
. Preliminary data suggests the humoral response rate for solid organ transplant patients who have received both doses of SARs‐CoV‐2 mRNA vaccine, either mRNA‐1273 (Moderna) or BNT162b2 (Pfizer‐BioNTech), is roughly 54%
3
. However, the clinical implications and real life impact of this is still unknown.
To the Editor, Cytomegalovirus (CMV) infections cause significant morbidity and mortality among all solid organ transplant recipients. CMV discordant (D+/R−) recipients are at higher risk of developing CMV viremia after cessation of prophylaxis. 1 CMV-specific T-cell-mediated immunity (CMI) has been shown in previous studies to predict those at the highest risk for CMV-associated events. 2-4 However, it is unknown if changes in maintenance immunosuppression guided by CMI may lead to fewer CMV events as a result of improved immunity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.