Efficacy and Mechanisms of Dapagliflozin in Promoting Kidney Function and Cardiovascular Health in Kidney Transplant Recipients

Description

Long-term allograft function in kidney transplant recipients (KTRs) remain suboptimal, and graft failure causes significant morbidity and mortality, with cardiovascular disease being the leading cause of death in KTRs and the most common cause of death with a functioning graft. Sodium-glucose cotransporter 2 (SGLT2) inhibitors safely lower cardiovascular and kidney disease risk in the non-transplant population, yet data in KTRs are lacking. This clinical trial seeks to establish the efficacy and safety of dapagliflozin, a SGLT2 inhibitor, for improving cardiovascular and kidney graft function in adult KTRs with type 2 diabetes and post-transplant diabetes, and to leverage innovate translational methods to define the underlying mechanisms of action.

Conditions

Kidney Transplant; Complications, Vascular Diseases, Diabetes

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Study Details

Study overview

Long-term allograft function in kidney transplant recipients (KTRs) remain suboptimal, and graft failure causes significant morbidity and mortality, with cardiovascular disease being the leading cause of death in KTRs and the most common cause of death with a functioning graft. Sodium-glucose cotransporter 2 (SGLT2) inhibitors safely lower cardiovascular and kidney disease risk in the non-transplant population, yet data in KTRs are lacking. This clinical trial seeks to establish the efficacy and safety of dapagliflozin, a SGLT2 inhibitor, for improving cardiovascular and kidney graft function in adult KTRs with type 2 diabetes and post-transplant diabetes, and to leverage innovate translational methods to define the underlying mechanisms of action.

Efficacy and Mechanisms of Dapagliflozin in Promoting Kidney Function and Cardiovascular Health in Kidney Transplant Recipients

Efficacy and Mechanisms of Dapagliflozin in Promoting Kidney Function and Cardiovascular Health in Kidney Transplant Recipients

Condition
Kidney Transplant; Complications
Intervention / Treatment

-

Contacts and Locations

Aurora

University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States, 80045

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Age 18-80 years
  • * Kidney transplant received 1 year prior to randomization
  • * estimated glomerular filtration rate 30-90 ml/min/1.73m2
  • * Urine albumin to creatinine ratio (ACR) 30-5000 mg/g
  • * Pre-existing type 2 diabetes or post-transplant diabetes mellitus
  • * Blood pressure \<130/80 mm Hg prior to randomization
  • * Able to provide informed consent
  • * Stable immunosuppression for at least 3 months prior to baseline consisting of tacrolimus, mycophenolate mofetil/mycophenolic acid and prednisone
  • * Stable anti-hypertensive regimen for at least 1month prior to baseline
  • * Stable diabetes management for at least 3 months prior to baseline
  • * Stable angiotensin converting enzyme inhibitor/angiotensin receptor blocker use for at least 3 months prior to baseline (if applicable)
  • * Glucagon-like peptide-1 receptor agonist (GLP-1RA) for at least 3 months prior to baseline (if applicable)
  • * Type 1 diabetes
  • * Anticipated life expectancy \<1 year
  • * Uncontrolled hypertension
  • * Hemoglobin A1c \>9%
  • * Body mass index \>40 kg/m2
  • * New York Heart Association Class 3 or 4 heart failure symptoms, an EF ≤30%, or hospitalization for heart failure in the past 3 months
  • * Pregnancy, plans to become pregnant, or breastfeeding
  • * Current use of sodium glucose cotransporter-2 (SGLT2) inhibitors
  • * Current urinary or urogenital infection
  • * Use of anticoagulants (contraindication to kidney biopsy)
  • * Magnetic resonance imaging (MRI) contraindications
  • * History of lower-limb amputation irrespective of etiology
  • * Known hypersensitivity to dapagliflozin

Ages Eligible for Study

18 Years to 80 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of Colorado, Denver,

Study Record Dates

2028-12-31