This is an open label, randomized controlled study. We'd like to access the safety and effects of empagliflozin compared with linagliptin in new-onset diabetes after kidney transplantation patients. Our primary endpoints are kidney related indicators and secondary endpoints are glucose and lipid metabolism related indicators and adverse events. We are going to recruit 35 patients for each group and follow six months.
In recent years, with the development of transplantation technology and immunosuppressive agents, kidney transplantation has made considerable progress. However, for metabolic disorders after kidney transplantation, such as new diabetes after kidney transplantation, there is still insufficient awareness. Since 1964, Starlz et al. first discovered and proposed New-onset diabetes after kidney transplantation(NODAT) in patients after renal transplantation. Scholars from all countries have paid considerable attention to it. The Chinese guidelines indicate that NODAT can increase the risk of graft-related complications, such as rejection, graft loss and infection, and ultimately affect the long-term survival of the recipient. In addition, NODAT has also been shown to increase the risk of cardiovascular events, and cardiovascular disease is associated with more than half of kidney transplant deaths. A retrospective study of 567 renal transplant recipients in China showed that the incidence of NODAT was 24.2%. It can be seen that the incidence of new-onset diabetes after renal transplantation is high and has long-term adverse effects on transplant patients. Therefore, there is an urgent need to evaluate and investigate NODAT's therapeutic drug regimens. According to the study, empagliflozin has a protective effect on the kidney and cardiovascular system, but it has not yet been written into the treatment guidelines for new-onset diabetes after kidney transplantation. Metformin and linagliptin are frequently used in diabetics after renal transplantation, and linagliptin also have a protective effect on the kidneys. Therefore, this experiment wanted to compare the effects between empagliflozin and linagliptin on kidney protection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Dosage adjustment based on glucose targets . Once daily
Dosage adjustment based on glucose targets. Once daily
Department of nephrology, endocrinology and kidney transplantation , Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, China
eGFR
the change from baseline in estimated glomerular filtration rate calculated by MDRD formula
Time frame: 24 weeks
Graft loss rate
the frequency of patients' graft loss or dysfunction
Time frame: 24 weeks
Mortality rate
the patients' death rate related to treatment and transplantation with in 24 weeks after treatment
Time frame: 24 weeks
Acute rejection
the frequency of acute rejection
Time frame: 24 weeks
Progression to albuminuria
the frequency of macroalbuminuria
Time frame: 24 weeks
Progression to macroalbuminuria
the frequency of macroalbuminuria
Time frame: 24 weeks
Fasting plasma glucose
Change from baseline in fasting plasma glucose
Time frame: 24 weeks
Glycated hemoglobin (HbA1c)
Change from baseline in HbA1c
Time frame: 24 weeks
Adverse events
Record adverse events that related to treatment and transplantation
Time frame: 24 weeks
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