Supported Research

Supervisor(s):  David Cherney

Lay Abstract

Background: Approximately 4 million Canadians live with chronic kidney disease, a progressive condition which worsens over time leading to kidney failure. Individuals with kidney failure suffer from disability, depression, increased rates of hospitalization and death. Kidney failure also results in increased healthcare spending and additional societal costs related to disability.
 
Kidney transplantation is the best treatment option for kidney replacement therapy due to improved survival and quality of life over other treatment modalities. However, KTR have an increased risk of death due to heart disease and graft failure, where the transplanted kidney no longer works and dialysis or another kidney transplant is required. The risk of death is higher in the presence of diabetes, which is common in KTR. While there are medications to help manage diabetes, effective treatments which protect heart and kidney function in KTR are lacking.
 
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA) are two new types of drugs for diabetes management which have shown significant benefits in protecting heart and kidney function in non-transplanted individuals. Preliminary evidence suggests these benefits may extend to the KTR population.
 
Purpose: To investigate the effects of SGLT2i or GLP1RA on heart and kidney function in KTR.
 
Methods: Electronic medical records of KTR will be reviewed to compare kidney and heart function in patients who have used SGLT2i or GLP1RA versus patients who have not used either drug.
 
Anticipated outcome: The use of SGLT2i or GLP1RA in KTR is expected to provide protective benefits.
 
Patient Engagement: Patient partners will not be involved initially as the study is observational in nature, and the data has already been partially collected. Patient engagement will occur at the end of the analysis to understand how to interpret the data and what next steps to take.
 
Relevance to Patients/Community: Our results will add to an emerging body of evidence which supports the use of SGLT2i or GLP1RA in KTR. This may encourage transplant nephrologists to incorporate these new drugs in the care of KTR, possibly leading to improved health outcomes and reduced healthcare costs related to hospitalization and graft loss.
 
Conclusion: The study will investigate the utility of new glucose lowering therapies SGLT2i and GLP1RA in improving health outcomes in KTR. Study findings will be used to design and implement new studies in this field.