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P8.021 Study the effect of sodium-glucose cotransporter-2 inhibition versus dipeptidyl peptidase-4 inhibition in diabetic kidney transplant recipients

Osama Ashry Gheith, Egypt

Mansoura university

Biography

Biography

I am Dr. Osama Ashry Ahmed Gheith, who graduated in 1987 from Mansoura faculty of medicine, Egypt. I have held an MD degree in Internal Medicine and Nephrology since 2003. I have been trained at Mansoura urology and nephrology center, Mansoura University, Egypt from 1991 till 2008 when I join the work at Hamed Al-Essa organ transplant center.

I am a member of the following societies: International Society of Nephrology (ISN), European Dialysis Transplantation Association (EDTA), African Association of Nephrology (AFRAN), Arab Society of Nephrology, and Egyptian Society of Nephrology (ESN).

I have long experience with all nephrology activities including all dialysis modalities, medical care of more than 3500 renal transplant recipients, and surgical Skills of importance in the field of nephrology as vascular access creation, PD catheter insertion, and renal biopsies. Moreover, I am interested in training and supervising Junior Staff in nephrology and renal transplant (in Egypt, Yemen, and Kuwait).

I have completed the NIH Web-based training course “Protecting Human Research Participants”. I am interested in research work and have over 12 research projects ongoing in the department. I am an author and/or co-author of over 85 publications in peer-reviewed international journals. In addition to several abstracts in many Middle East and international conferences. I am interested in the field of immunosuppression in renal transplantation, post-transplant diabetes, infection, and anemia.

I won some of the research prizes with the special concern of Emirates medical association –Nephrology Society EMAN YOUNG INVESTIGATOR AWARD –during the 12th congress of the Arab society of nephrology and renal transplantation 2014, 6th ISN EMAN Update Course in Nephrology 2014, 10-13December 2014 Dubai, UAE; one of the top 5 posters presented in ESNT 2018 (impact of HLA DR mismatch in elderly renal transplant recipients regardless donor sources: single-center experience from the middle east) and one of the top 5 posters presented in ESNT 2019 (Screening for BK viremia/viruria and the Impact of Management of BK Virus Nephropathy in Renal Transplant Recipients).

Abstract

Study the effect of sodium-glucose cotransporter-2 inhibition versus dipeptidyl peptidase-4 inhibition in diabetic kidney transplant recipients

Torki Aotaibi1, Osama Gheith1,2, Zakaria Elsayed1, Ahmed Yahya1, Mohamed Shaker1, Mahmoud Khalid1, Mohamed Emam1, Mohamed Mostafa1, Mohamed Abdul-Hameed1, Ayman Maher1,2, Ahmed Denewar1, Mohamed Dahab1, Nabil Elserwy1, Nashwa Othman4, Prasad Nair1.

1Nephrology , OTC kuwait, Kuwait, Kuwait; 2Nephrology , MUNC, mansoura, Egypt; 3Public health, Faculty of Nursing , Mansoura, Egypt; 4Education , Dasman diabetes institute, Kuwait, Kuwait

Introduction: Diabetes is the most common cause of chronic kidney disease (CKD) globally. The renal and cardio-vascular benefits of the new anti-diabetic agents are not assessed comprehensively. 

Aim of the study: We aimed to evaluate the short-term renal and cardio-protective effects of Sodium-Glucose Cotransporter-2 Inhibition (SGLT2i) Vs. Dipeptidyl peptidase-4 Inhibition (DPP4i) among diabetic kidney transplant recipients.

Patients and methods: In this observational trial, 222 diabetic kidney transplants recipients (NODAT or type 2 diabetes) were enrolled and were categorized into two groups. Group 1 (n=99) received SGLT2i while group 2(n=123) received DPP4i as an add on antidiabetic medications. All patients in the two groups were followed up for 12 months.

Results: Most patients in the two groups (1&2) were men (59.6 vs. 61.7%, p=0.73) in their middle age (58.5±11.9 vs. 54.4±12.9, p=0.016) years respectively. The two groups were matched regarding their demographics especially the type of donor, type of immunosuppression (induction or maintenance), number of cardiovascular events before enrollment in the study, and the number of patients who were maintained on ACEi or ARB(p>0.05).
The minority of patients were smokers (12.9 vs.8.7%), and chronic glomerulonephritis was the original disease in 36.4 vs. 35.4% in the two groups, respectively. Most of the enrolled patients (72.8 vs. 78.6%) underwent hemodialysis pre-transplant. During the follow-up period, patients in both groups were comparable regarding mean blood pressure, body weight, HbA1C, 24-hour urine protein, and graft function (represented by the mean serum creatinine) at different time intervals and compared to baseline values(p>0.05). However, the mean HbA1C was significantly higher in group 1 during the whole follow-up period of the study (p<0.05) but it did not drop significantly compared to baseline values (p>0.05). We did not report any macroangiopathic events (cerebral stroke, acute myocardial infection, or peripheral arterial disease) in the two groups during the study.

Conclusion: Both GLT2i and DPP-4 I are comparable regarding renal and cardiovascular protection among diabetic kidney transplant recipients.

Keywords: DM, renal protection, kidney transplant

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