{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:39:08Z","timestamp":1790685548788,"version":"4.1.0"},"reference-count":105,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PNRR","award":["PNRR-MCNT2-2023-12378319"],"award-info":[{"award-number":["PNRR-MCNT2-2023-12378319"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Diabetes mellitus (DM) is frequent in kidney transplant recipients (KTRs), reducing graft and patient survival. In recent years, hypoglycemic agents have been approved for chronic kidney disease (CKD) patients, such as sodium glucose co-transporter type 2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP1RAs), and nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs), such as finerenone. Several studies demonstrated the ability of these drugs to reduce cardiovascular (CV) events and kidney disease progression in diabetic CKD patients. In this review, we will describe their use in KTRs with type 2 DM or post-transplant diabetes mellitus (PTDM), focusing on the potential positive effects. In particular, we will report literature data from observational studies, meta-analyses, and clinical trials. Based on their mechanism of actions, these drugs may balance the negative effects of immunosuppressive therapy on metabolic balance, reducing the risk of PTDM and CV events, that remain the first cause of death in KTRs. Generally, SGLT2is and GLP1RAs appear to be safe and efficacious in KTRs, and no interaction with immunosuppressive drugs or an increased risk of rejection has been reported. Regarding finerenone, no literature data are available and only one clinical trial is ongoing. In conclusion, although the 2022 KDIGO guidelines recommend caution in KTRs, the last meeting in Vienna on PTDM encourages their use in this population.<\/jats:p>","DOI":"10.3390\/ijms26135952","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T11:23:24Z","timestamp":1750418604000},"page":"5952","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diabetes Mellitus in Kidney Transplant Recipients and New Hypoglycemic Agent Options"],"prefix":"10.3390","volume":"26","author":[{"given":"Giulia","family":"Bartoli","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, Policlinico Universitario Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Dello Strologo","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Nephrology and Dialysis, Azienda USL Roma 6, 00040 Albano Laziale, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Arena","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jos\u00e8","family":"Ceravolo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Policlinico Universitario Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0132-386X","authenticated-orcid":false,"given":"Anna Paola","family":"Mitterhofer","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Policlinico Universitario Tor Vergata, 00133 Rome, Italy"},{"name":"Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2882-4226","authenticated-orcid":false,"given":"Francesco","family":"Pesce","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Division of Renal Medicine, Ospedale Isola Tiberina\u2014Gemelli Isola, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Grandaliano","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Nephrology, Dialysis and Transplantation Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/ckj\/sfx117","article-title":"A Comparative Analysis of Survival of Patients on Dialysis and after Kidney Transplantation","volume":"11","author":"Kaballo","year":"2018","journal-title":"Clin. Kidney J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1111\/j.1600-6143.2011.03686.x","article-title":"Systematic Review: Kidney Transplantation Compared with Dialysis in Clinically Relevant Outcomes","volume":"11","author":"Tonelli","year":"2011","journal-title":"Am. J. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00592-024-02253-w","article-title":"Prevalence of New-Onset Diabetes Mellitus after Kidney Transplantation: A Systematic Review and Meta-Analysis","volume":"61","author":"Du","year":"2024","journal-title":"Acta Diabetol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.ajt.2024.01.012","article-title":"OPTN\/SRTR 2022 Annual Data Report: Kidney","volume":"24","author":"Lentine","year":"2024","journal-title":"Am. J. Transplant."},{"key":"ref_5","first-page":"SS3","article-title":"New-Onset Diabetes after Transplantation: 2003 International Consensus Guidelines. Proceedings of an International Expert Panel Meeting. Barcelona, Spain, 19 February 2003","volume":"75","author":"Davidson","year":"2003","journal-title":"Transplantation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.1111\/ajt.12850","article-title":"Proceedings from an International Consensus Meeting on Posttransplantation Diabetes Mellitus: Recommendations and Future Directions","volume":"14","author":"Sharif","year":"2014","journal-title":"Am. J. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s11892-015-0601-x","article-title":"The Diagnosis of Posttransplantation Diabetes Mellitus: Meeting the Challenges","volume":"15","author":"Werzowa","year":"2015","journal-title":"Curr. Diabetes Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/tri.13783","article-title":"Management of Post-Transplant Diabetes: Immunosuppression, Early Prevention, and Novel Antidiabetics","volume":"34","author":"Hecking","year":"2021","journal-title":"Transpl. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/TP.0b013e3182a012f3","article-title":"Screening for New-Onset Diabetes after Kidney Transplantation: Limitations of Fasting Glucose and Advantages of Afternoon Glucose and Glycated Hemoglobin","volume":"96","author":"Yates","year":"2013","journal-title":"Transplantation"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee, ElSayed, N.A., McCoy, R.G., Aleppo, G., Balapattabi, K., Beverly, E.A., Briggs Early, K., Bruemmer, D., Ebekozien, O., and Echouffo-Tcheugui, J.B. (2025). 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes\u20142025. Diabetes Care, 48, S27\u2013S49.","DOI":"10.2337\/dc25-S002"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1053\/j.ackd.2021.10.004","article-title":"Diabetes in Kidney Transplantation","volume":"28","year":"2021","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1177\/039139880803100801","article-title":"Hepatitis C Virus Infection and Post-Transplant Diabetes Mellitus among Renal Transplant Patients: A Meta-Analysis","volume":"31","author":"Fabrizi","year":"2008","journal-title":"Int. J. Artif. Organs"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2415","DOI":"10.1111\/j.1523-1755.2005.00349.x","article-title":"New Onset Hyperglycemia and Diabetes Are Associated with Increased Cardiovascular Risk after Kidney Transplantation","volume":"67","author":"Cosio","year":"2005","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"732","DOI":"10.2215\/CJN.09310819","article-title":"Metabolic Disorders with Kidney Transplant","volume":"15","author":"Cohen","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1111\/ajt.12236","article-title":"The Higher Diabetogenic Risk of Tacrolimus Depends on Pre-Existing Insulin Resistance. A Study in Obese and Lean Zucker Rats","volume":"13","author":"Porrini","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.4239\/wjd.v6.i8.1073","article-title":"Steroid Hyperglycemia: Prevalence, Early Detection and Therapeutic Recommendations: A Narrative Review","volume":"6","year":"2015","journal-title":"World J. Diabetes"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/TP.0000000000002815","article-title":"Diabetogenic Effects of Immunosuppression: An Integrative Analysis","volume":"104","author":"Bhat","year":"2020","journal-title":"Transplantation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/00007890-199908150-00012","article-title":"Islet Cell Damage Associated with Tacrolimus and Cyclosporine: Morphological Features in Pancreas Allograft Biopsies and Clinical Correlation","volume":"68","author":"Drachenberg","year":"1999","journal-title":"Transplantation"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Granata, S., Mercuri, S., Troise, D., Gesualdo, L., Stallone, G., and Zaza, G. (2023). mTOR-Inhibitors and Post-Transplant Diabetes Mellitus: A Link Still Debated in Kidney Transplantation. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1168967"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1126\/science.1215135","article-title":"Rapamycin-Induced Insulin Resistance Is Mediated by mTORC2 Loss and Uncoupled from Longevity","volume":"335","author":"Lamming","year":"2012","journal-title":"Science"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1053\/j.ajkd.2020.07.016","article-title":"Glucose Metabolism After Kidney Transplantation: Insulin Release and Sensitivity with Tacrolimus- Versus Belatacept-Based Immunosuppression","volume":"77","author":"Schwaiger","year":"2021","journal-title":"Am. J. Kidney Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/ndt\/gfad258","article-title":"International Consensus on Post-Transplantation Diabetes Mellitus","volume":"39","author":"Sharif","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1056\/NEJMoa1811744","article-title":"Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy","volume":"380","author":"Perkovic","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"The EMPA-KIDNEY Collaborative Group (2023). Empagliflozin in Patients with Chronic Kidney Disease. N. Engl. J. Med., 388, 117\u2013127.","DOI":"10.1056\/NEJMoa2204233"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/S2213-8587(19)30249-9","article-title":"Cardiovascular, Mortality, and Kidney Outcomes with GLP-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Cardiovascular Outcome Trials","volume":"7","author":"Kristensen","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Nauck, M.A., and Quast, D.R. (2021). Cardiovascular Safety and Benefits of Semaglutide in Patients with Type 2 Diabetes: Findings From SUSTAIN 6 and PIONEER 6. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.645566"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1093\/eurheartj\/ehab777","article-title":"Cardiovascular and Kidney Outcomes with Finerenone in Patients with Type 2 Diabetes and Chronic Kidney Disease: The FIDELITY Pooled Analysis","volume":"43","author":"Agarwal","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2022.06.008","article-title":"KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease","volume":"102","author":"Rossing","year":"2022","journal-title":"Kidney Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1210\/clinem\/dgad395","article-title":"Posttransplant Diabetes Mellitus: Recent Developments in Pharmacological Management of Hyperglycemia","volume":"109","author":"Cusi","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1177\/1060028020951955","article-title":"Review of Newer Antidiabetic Agents for Diabetes Management in Kidney Transplant Recipients","volume":"55","author":"Anderson","year":"2021","journal-title":"Ann. Pharmacother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2887","DOI":"10.1681\/ASN.2020050566","article-title":"Death after Kidney Transplantation: An Analysis by Era and Time Post-Transplant","volume":"31","author":"Ying","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.tem.2020.04.002","article-title":"CREDENCE: Significant Victory for Diabetic Kidney Disease","volume":"31","author":"Verma","year":"2020","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in Patients with Chronic Kidney Disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100608","DOI":"10.1016\/j.xkme.2023.100608","article-title":"Sodium Glucose Cotransporter 2 (SGLT2) inhibitors and CKD: Are You a #Flozinator?","volume":"5","author":"Krishnan","year":"2023","journal-title":"Kidney Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/MNH.0000000000000584","article-title":"Renal Effects of SGLT2 Inhibitors: An Update","volume":"29","author":"Nespoux","year":"2020","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1146\/annurev-physiol-031620-095920","article-title":"Effects of SGLT2 Inhibitors on Kidney and Cardiovascular Function","volume":"83","author":"Vallon","year":"2021","journal-title":"Annu. Rev. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1111\/j.1365-2362.2010.02317.x","article-title":"Advanced Glycation End-Products and the Kidney","volume":"40","author":"Busch","year":"2010","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"154324","DOI":"10.1016\/j.metabol.2020.154324","article-title":"Dapagliflozin Promotes Beta Cell Regeneration by Inducing Pancreatic Endocrine Cell Phenotype Conversion in Type 2 Diabetic Mice","volume":"111","author":"Wei","year":"2020","journal-title":"Metabolism"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1093\/ckj\/sfaa133","article-title":"Effects of Canagliflozin on Serum Potassium in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program","volume":"14","author":"Weir","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/dom.13101","article-title":"Effects of Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors on Serum Uric Acid Level: A Meta-Analysis of Randomized Controlled Trials","volume":"20","author":"Zhao","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1161\/CIRCULATIONAHA.119.044235","article-title":"Effect of Empagliflozin on Erythropoietin Levels, Iron Stores, and Red Blood Cell Morphology in Patients with Type 2 Diabetes Mellitus and Coronary Artery Disease","volume":"141","author":"Mazer","year":"2020","journal-title":"Circulation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1053\/j.ajkd.2020.04.016","article-title":"Mechanisms Leading to Differential Hypoxia-Inducible Factor Signaling in the Diabetic Kidney: Modulation by SGLT2 Inhibitors and Hypoxia Mimetics","volume":"77","author":"Packer","year":"2021","journal-title":"Am. J. Kidney Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.kint.2020.02.041","article-title":"The Role of Renal Hypoxia in the Pathogenesis of Diabetic Kidney Disease: A Promising Target for Newer Renoprotective Agents Including SGLT2 Inhibitors?","volume":"98","author":"Hesp","year":"2020","journal-title":"Kidney Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/s41581-021-00393-8","article-title":"Pathophysiology of Diabetic Kidney Disease: Impact of SGLT2 Inhibitors","volume":"17","author":"DeFronzo","year":"2021","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Mascolo, A., Di Napoli, R., Balzano, N., Cappetta, D., Urbanek, K., De Angelis, A., Scisciola, L., Di Meo, I., Sullo, M.G., and Rafaniello, C. (2022). Safety Profile of Sodium Glucose Co-Transporter 2 (SGLT2) Inhibitors: A Brief Summary. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.1010693"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"764","DOI":"10.7326\/M19-0085","article-title":"Fournier Gangrene Associated with Sodium\u2013Glucose Cotransporter-2 Inhibitors: A Review of Spontaneous Postmarketing Cases","volume":"170","author":"Chamberlain","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e2886","DOI":"10.1002\/dmrr.2886","article-title":"Ketosis and Diabetic Ketoacidosis in Response to SGLT2 Inhibitors: Basic Mechanisms and Therapeutic Perspectives","volume":"33","author":"Qiu","year":"2017","journal-title":"Diabetes Metab. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"20420188221090001","DOI":"10.1177\/20420188221090001","article-title":"Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in Kidney Transplant Recipients: What Is the Evidence?","volume":"13","author":"Ujjawal","year":"2022","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.1056\/NEJMra064928","article-title":"Infection in Solid-Organ Transplant Recipients","volume":"357","author":"Fishman","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1097\/00007890-199405000-00008","article-title":"The Hyperfiltration Hypothesis in Human Renal Transplantation","volume":"57","author":"Terasaki","year":"1994","journal-title":"Transplantation"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1021\/acs.jproteome.6b00956","article-title":"Combined Clinical Phenotype and Lipidomic Analysis Reveals the Impact of Chronic Kidney Disease on Lipid Metabolism","volume":"16","author":"Chen","year":"2017","journal-title":"J. Proteome Res."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Polychronopoulou, E., Bourdon, F., and Teta, D. (2024). SGLT2 Inhibitors in Diabetic and Non-Diabetic Kidney Transplant Recipients: Current Knowledge and Expectations. Front. Nephrol., 4.","DOI":"10.3389\/fneph.2024.1332397"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.transproceed.2019.11.007","article-title":"Outcomes of SGLT2 Inhibitors Use in Diabetic Renal Transplant Patients","volume":"52","author":"AlKindi","year":"2020","journal-title":"Transplant. Proc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.2337\/dc19-0093","article-title":"Efficacy and Safety of Empagliflozin in Renal Transplant Recipients with Posttransplant Diabetes Mellitus","volume":"42","author":"Halden","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1159\/000501854","article-title":"Sodium-Glucose Cotransporter 2 (SGLT2) Inhibition in Kidney Transplant Recipients with Diabetes Mellitus","volume":"44","author":"Mahling","year":"2019","journal-title":"Kidney Blood Press. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/ajt.15223","article-title":"Empagliflozin in Posttransplantation Diabetes Mellitus: A Prospective, Interventional Pilot Study on Glucose Metabolism, Fluid Volume, and Patient Safety","volume":"19","author":"Schwaiger","year":"2019","journal-title":"Am. J. Transplant."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e00185","DOI":"10.1002\/edm2.185","article-title":"Early Initiation of Sodium-Glucose Linked Transporter Inhibitors (SGLT-2i) and Associated Metabolic and Electrolyte Outcomes in Diabetic Kidney Transplant Recipients","volume":"4","author":"Song","year":"2021","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e404","DOI":"10.1097\/TP.0000000000004228","article-title":"The Efficacy and Safety of SGLT2 Inhibitor in Diabetic Kidney Transplant Recipients","volume":"106","author":"Lim","year":"2022","journal-title":"Transplantation"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1093\/ckj\/sfad007","article-title":"Sodium-Glucose Cotransporter-2 Inhibitor Therapy in Kidney Transplant Patients with Type 2 or Post-Transplant Diabetes: An Observational Multicentre Study","volume":"16","year":"2023","journal-title":"Clin. Kidney J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"10043","DOI":"10.1038\/s41467-024-54171-8","article-title":"The Outcomes of SGLT-2 Inhibitor Utilization in Diabetic Kidney Transplant Recipients","volume":"15","author":"Sheu","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Sanchez-Baya, M., Bolufer, M., V\u00e1zquez, F., Alonso, N., Mass\u00f3, E., Paul, J., Coll-Brito, V., Taco, O., Anton-Pampols, P., and Gelpi, R. (2025). Diabetes Mellitus in Kidney Transplant Recipients: New Horizons in Treatment. J. Clin. Med., 14.","DOI":"10.3390\/jcm14041048"},{"key":"ref_63","unstructured":"(2025, May 02). CardioRenal Effects of SGLT2 Inhibition in Kidney Transplant Recipients (CREST-KT) ClinicalTrials.gov ID NCT04906213, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04906213."},{"key":"ref_64","unstructured":"(2025, May 02). Efficacy, Mechanisms and Safety of SGLT2 Inhibitors in Kidney Transplant Recipients (INFINITI2019) ClinicalTrials.gov ID NCT04965935, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04965935."},{"key":"ref_65","unstructured":"(2025, May 02). SGLT2i in Diabetic Patients with Renal Transplantation ClinicalTrials.gov ID NCT06731231, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06731231."},{"key":"ref_66","unstructured":"(2025, May 02). Empagliflozin Treatment in Kidney Transplant Recipients (SEKTR) ClinicalTrials.gov ID NCT06013865, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06013865."},{"key":"ref_67","unstructured":"(2025, May 02). The RENAL LIFECYCLE Trial: A RCT to Assess the Effect of Dapagliflozin on Renal and Cardiovascular Outcomes in Patients with Severe CKD ClinicalTrials.gov ID NCT05374291, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05374291."},{"key":"ref_68","unstructured":"(2025, May 02). The Efficacy, Mechanism & Safety of Sodium Glucose Co-Transporter-2 Inhibitor & Glucagon-Like Peptide 1 Receptor Agonist Combination Therapy in Kidney Transplant Recipients (HALLMARK) ClinicalTrials.gov ID NCT05938712, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05938712."},{"key":"ref_69","unstructured":"(2025, May 02). Effect of Adding Dapagliflozin to Allograft Dysfunction of Renal Transplanted Patients. ClinicalTrials.gov ID NCT04743453, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04743453."},{"key":"ref_70","unstructured":"Effect of Empagliflozin, vs. (2025, May 02). Linagliptin on Glycemic Outcomes, Renal Outcomes & Body Composition in Renal Transplant Recipients with Diabetes Mellitus (EmLinaRenal) ClinicalTrials.gov ID NCT06095492, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06095492."},{"key":"ref_71","unstructured":"(2025, May 02). Can Dapagliflozin Preserve Structure and Function in Transplanted Kidneys? (DEAKTransplant) ClinicalTrials.gov ID NCT05788276, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05788276."},{"key":"ref_72","unstructured":"(2025, May 02). Acute Effects of SGLT2 Inhibitor on Kidney Allograft Oxygen Tension (SGL-TX-MR) ClinicalTrials.gov ID NCT06933355, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06933355."},{"key":"ref_73","unstructured":"(2025, May 02). Effects of Empagliflozin in Reducing Oxidative Stress After Kidney Transplantation ClinicalTrials.gov ID NCT04918407, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04918407."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1056\/NEJMoa1901118","article-title":"Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes","volume":"381","author":"Husain","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S2213-8587(18)30104-9","article-title":"Dulaglutide versus Insulin Glargine in Patients with Type 2 Diabetes and Moderate-to-Severe Chronic Kidney Disease (AWARD-7): A Multicentre, Open-Label, Randomised Trial","volume":"6","author":"Tuttle","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1056\/NEJMoa1603827","article-title":"Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1038\/s41574-022-00783-3","article-title":"Beyond the Pancreas: Contrasting Cardiometabolic Actions of GIP and GLP1","volume":"19","author":"Hammoud","year":"2023","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cmet.2023.11.009","article-title":"Central Glucagon-like Peptide 1 Receptor Activation Inhibits Toll-like Receptor Agonist-Induced Inflammation","volume":"36","author":"Wong","year":"2024","journal-title":"Cell Metab."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"sfae250","DOI":"10.1093\/ckj\/sfae250","article-title":"Semaglutide-Associated Kidney Injury","volume":"17","author":"Begum","year":"2024","journal-title":"Clin. Kidney J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2555","DOI":"10.2147\/DDDT.S470826","article-title":"Clinical Pharmacokinetics of Semaglutide: A Systematic Review","volume":"18","author":"Yang","year":"2024","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_82","first-page":"100343","article-title":"Safety and Efficacy of Semaglutide in Post Kidney Transplant Patients with Type 2 Diabetes or Post-Transplant Diabetes","volume":"36","author":"Mahzari","year":"2024","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1210\/clinem\/dgad177","article-title":"Possible Advantage of Glucagon-Like Peptide 1 Receptor Agonists for Kidney Transplant Recipients with Type 2 Diabetes","volume":"108","author":"Sato","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"101624","DOI":"10.1016\/j.diabet.2025.101624","article-title":"Glucagon-Like Peptide 1 Receptor Agonists and Renal Outcomes in Kidney Transplant Recipients with Diabetes Mellitus","volume":"51","author":"Rudman","year":"2025","journal-title":"Diabetes Metab."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e15144","DOI":"10.1111\/ctr.15144","article-title":"Sodium-Glucose Co-Transporter 2 Inhibitors & Glucagon-like Peptide-1 Receptor Agonists, Efficacy & Safety in Diabetic Kidney Transplant Recipients","volume":"37","author":"Mahmoud","year":"2023","journal-title":"Clin. Transplant."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.nefroe.2024.11.007","article-title":"Use of Glucagon-like Peptide Type 1 Receptor Agonists in Kidney Transplant Recipients","volume":"44","author":"Vigara","year":"2024","journal-title":"Nefrologia (Engl. Ed.)"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1097\/TP.0000000000004945","article-title":"Glucagon-like Peptide 1 Receptor Agonists and Cardiovascular Outcomes in Solid Organ Transplant Recipients with Diabetes Mellitus","volume":"108","author":"Dotan","year":"2024","journal-title":"Transplantation"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/S2213-8587(24)00371-1","article-title":"GLP-1 Receptor Agonists in Kidney Transplant Recipients with Pre-Existing Diabetes: A Retrospective Cohort Study","volume":"13","author":"Orandi","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"sfae018","DOI":"10.1093\/ckj\/sfae018","article-title":"Safety and Efficacy of Glucagon-like Peptide-1 Receptor Agonists among Kidney Transplant Recipients: A Systematic Review and Meta-Analysis","volume":"17","author":"Krisanapan","year":"2024","journal-title":"Clin. Kidney J."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.transproceed.2024.02.026","article-title":"Combination of SGLT2 Inhibitors and GLP-1 Receptor Agonists in PTDM Treatment in Kidney Transplant Recipients: Synergistic Effect with Added Value in Terms of Nephroprotection","volume":"56","author":"Juric","year":"2024","journal-title":"Transplant. Proc."},{"key":"ref_91","unstructured":"(2025, May 02). Semaglutide Treatment for Hyperglycaemia After Renal Transplantation (Sema-RTx). ClinicalTrials.gov ID NCT05702931, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05702931."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Bellos, I., Lagiou, P., Benetou, V., and Marinaki, S. (2024). Safety and Efficacy of Sodium-Glucose Transport Protein 2 Inhibitors and Glucagon-like Peptide-1 Receptor Agonists in Diabetic Kidney Transplant Recipients: Synthesis of Evidence. J. Clin. Med., 13.","DOI":"10.3390\/jcm13206181"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Altheaby, A., Alajlan, N., Shaheen, M.F., Abosamah, G., Ghallab, B., Aldawsari, B., Rashidi, A., Gafar, M., and Arabi, Z. (2022). Weight Gain after Renal Transplant: Incidence, Risk Factors, and Outcomes. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268044"},{"key":"ref_94","unstructured":"(2025, May 02). Obesity Management for Kidney TRANSPLANTation: OK-TRANSPLANT 2. ClinicalTrials.gov ID NCT06396416, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06396416."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/eurheartj\/ehaa736","article-title":"Steroidal and Non-Steroidal Mineralocorticoid Receptor Antagonists in Cardiorenal Medicine","volume":"42","author":"Agarwal","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1007\/s40262-023-01312-9","article-title":"The Pharmacokinetics of the Nonsteroidal Mineralocorticoid Receptor Antagonist Finerenone","volume":"62","author":"Heinig","year":"2023","journal-title":"Clin. Pharmacokinet."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1093\/ndt\/gfy065","article-title":"Mineralocorticoid Receptor Antagonists in Kidney Transplantation: Time to Consider?","volume":"33","author":"Girerd","year":"2018","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1681\/ASN.2014121216","article-title":"Sulfenic Acid Modification of Endothelin B Receptor Is Responsible for the Benefit of a Nonsteroidal Mineralocorticoid Receptor Antagonist in Renal Ischemia","volume":"27","author":"Prince","year":"2016","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1681\/ASN.2016040477","article-title":"Benefit of Mineralocorticoid Receptor Antagonism in AKI: Role of Vascular Smooth Muscle Rac1","volume":"28","author":"Lechner","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_101","unstructured":"(2025, May 02). The EFfect of FinErenone in Kidney TransplantiOn Recipients: The EFFEKTOR Study ClinicalTrials.gov ID NCT06059664, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06059664."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"106062","DOI":"10.1016\/j.phrs.2022.106062","article-title":"Cognitive Impairment and Type 2 Diabetes Mellitus: Focus of SGLT2 Inhibitors Treatment","volume":"176","author":"Rizzo","year":"2022","journal-title":"Pharmacol. Res."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1210\/clinem\/dgac210","article-title":"Cardiovascular Benefits of Empagliflozin Are Associated with Gut Microbiota and Plasma Metabolites in Type 2 Diabetes","volume":"107","author":"Deng","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Mart\u00ednez, Y., Borriello, M., Capolongo, G., Ingrosso, D., and Perna, A.F. (2023). The Gut Microbiota in Kidney Transplantation: A Target for Personalized Therapy?. Biology, 12.","DOI":"10.3390\/biology12020163"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"sfae294","DOI":"10.1093\/ckj\/sfae294","article-title":"Cognitive Impairment in CKD Patients: A Guidance Document by the CONNECT Network","volume":"18","author":"Bolignano","year":"2025","journal-title":"Clin. 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