Novel Drugs for the Management of Diabetes Kidney Transplant Patients: A Literature Review

• Published in: Life (Basel, Switzerland) Vol. 13; no. 6; p. 1265
• Main Authors: Valencia-Morales, Nancy Daniela, Rodríguez-Cubillo, Beatriz, Loayza-López, Rómulo Katsu, Moreno de la Higuera, Maria Ángeles, Sánchez-Fructuoso, Ana Isabel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26.05.2023; MDPI
• Subjects: Agonists (Biochemistry); Cardiovascular disease; Care and treatment; Dextrose; Diabetes; Diabetes mellitus; Diabetes therapy; Diabetic nephropathies; Dosage and administration; Drug therapy; Drugs; Enzyme inhibitors; Forecasts and trends; Glucagon; Glucagon-like peptide 1; glucagon-like peptide 1 receptor agonists; Glucose; Hyperglycemia; Hypoglycemic agents; Immunosuppressive agents; Insulin resistance; Kidney diseases; kidney transplant; Kidney transplantation; Kidney transplants; Kidneys; Lifestyles; Literature reviews; Medical research; Medicine, Experimental; Mortality; Organ transplant recipients; Peptides; Population; Renal failure; Review; Side effects; sodium-glucose cotransporter type 2 inhibitors; Survival; Transplantation; Type 2 diabetes; Urinary tract; Urinary tract infections; Spain; kidney transplant; glucagon-like peptide 1 receptor agonists; diabetes; sodium-glucose cotransporter type 2 inhibitors
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life13061265

The management of diabetes and renal failure is changing thanks to the appearance of new drugs such as glucagon-like peptide 1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter type 2 inhibitors (SGLT2i) that have benefits in terms of survival and cardiorenal protection. Based on the potential mechanisms of GLP1-RA, kidney transplant recipients (KTRs) could benefit from their effects. However, high-quality studies are needed to demonstrate these benefits, in the transplant population, especially those related to cardiovascular benefits and renal protection. Studies with SGLT2i performed in KTRs are much less potent than in the general population and therefore no benefits in terms of patient or graft survival have been clearly demonstrated in this population to date. Additionally, the most frequently observed side effects could be potentially harmful to this population profile, including severe or recurrent urinary tract infections and impaired kidney function. However, benefits demonstrated in KTRs are in line with a known potential effects in cardiovascular and renal protection, which may be essential for the outcome of transplant recipients. Better studies are still needed to confirm the benefits of these new oral antidiabetics in the renal transplant population. Understanding the characteristics of these drugs may be critical for KTRs to be able to benefit from their effects without being damaged. This review discusses the results of the most important published studies on KTRs with GLP1-RA and SGLT2i as well as the potential beneficial effects of these drugs. Based on these results, approximate suggestions for the management of diabetes in KTRs were developed.