NCT06013865

Brief Summary

Kidney transplantation improves the health and quality of life for those Veterans with end stage kidney disease (ESKD). While early patient and graft survival are excellent, long-term outcomes continue to be challenging. Patient death with existing kidney graft function occurs in about half of all recipients over time. This is primarily due to the development of cardiovascular disease in a patient population with multiple preexisting cardiac disease risk factors. There has been little progress in improving outcomes in this area for over two decades. Recent studies in chronic kidney disease (CKD) patients using SGLT2 inhibitors (SGLT2i), regardless of the presence of type 2 diabetes mellitus (T2DM), results in both kidney protective and cardiac protective impacts and improved patient outcomes. However, kidney transplant recipients (KTRs) were excluded from these clinical trials due to concerns that these agents promote infection, diminish graft function, and may alter immunosuppressive drug levels that are the mainstay of patient's transplant therapy. There are limited published data of SGLT2i treatment of selected KTRs.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
264

participants targeted

Target at P75+ for phase_4

Timeline
48mo left

Started Apr 2024

Longer than P75 for phase_4

Geographic Reach
1 country

5 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress35%
Apr 2024Mar 2030

First Submitted

Initial submission to the registry

August 22, 2023

Completed
6 days until next milestone

First Posted

Study publicly available on registry

August 28, 2023

Completed
7 months until next milestone

Study Start

First participant enrolled

April 5, 2024

Completed
6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2030

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2030

Last Updated

April 21, 2026

Status Verified

April 1, 2026

Enrollment Period

6 years

First QC Date

August 22, 2023

Last Update Submit

April 16, 2026

Conditions

Keywords

TransplantDiabetesKidney FailureRejectionProteinuria

Outcome Measures

Primary Outcomes (1)

  • Discontinuation of Empagliflozin

    The incidence of therapeutic discontinuation of empagliflozin in the kidney transplant recipient from time of initiation.

    about 2 years

Secondary Outcomes (16)

  • Infection

    about 2 years

  • Hypoglycemia

    about 2 years

  • Major cardiorenal events

    about 2 years

  • Acute Graft Dysfunction

    about 2 years

  • Volume Depletion

    about 2 years

  • +11 more secondary outcomes

Study Arms (1)

Empagliflozin

OTHER

Open Label, Empagliflozin 12.5 mg QD

Drug: Empagliflozin

Interventions

SGLT2 Inhibitor

Also known as: jardiance
Empagliflozin

Eligibility Criteria

Age19 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult (\>18 years of age) male and female recipients (all races and ethnicities)
  • Subject must be able to understand and provide consent
  • Recipient of a primary or secondary kidney transplant at least 3 months or longer since transplant
  • For subjects with T2DM or post-transplant diabetes (PTDM), measured kidney function by CKD epi eGFR must be 30mL/min/1.73m2 to 59 mL/min/1.73m2 or CKD epi eGFR 60 mL/min/1.73m2 with urinary albumin:creatinine ratio 30 mg/g (or protein:creatinine 100 mg/g).
  • For subjects without T2DM or PTDM: measured kidney function by CKD epi eGFR must be 20mL/min/1.73m2 to 59mL/min/1.73m2 or CKD epi eGFR 60 mL/min/1.73m2 with urinary albumin:creatinine ratio 30 mg/g (or protein:creatinine 100 mg/g).

You may not qualify if:

  • Inability or unwillingness of a participant to give written informed consent or comply with study protocol
  • History of prior pancreas transplant
  • CKD epi eGFR \< 30 mL/min/1.73m2 for those with T2DM or \< 20 mL/min/1.73m2 for those without T2DM or anyone with 5mL/min/1.73m2 fall in eGFR per year
  • Uncontrolled type 2 diabetes mellitus with most recent A1C\>12%
  • History of \>2 urinary tract infections per year or UTIs requiring admission in the last year, or urosepsis in the last year.
  • Use of SGLT2i within 90 days
  • Documented allergy to SGLT2i
  • History of Type I diabetes mellitus
  • History of diabetic ketoacidosis
  • Indwelling foley catheter or urinary diversion
  • Acute rejection in the prior 3 months
  • Acute MACE event within 3 months of the study
  • Severe congestive heart failure (NYHA functional class III or higher)
  • Active mucocutaneous mycotic infection of the groin or external genitalia.
  • History of amputation due to peripheral vascular disease and/or diabetic foot ulcers within prior year
  • +6 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

Edward Hines Jr. VA Hospital, Hines, IL

Hines, Illinois, 60141-3030, United States

RECRUITING

Iowa City VA Health Care System, Iowa City, IA

Iowa City, Iowa, 52246-2292, United States

RECRUITING

Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE

Omaha, Nebraska, 68105-1850, United States

RECRUITING

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, 15240, United States

RECRUITING

Tennessee Valley Healthcare System Nashville Campus, Nashville, TN

Nashville, Tennessee, 37212-2637, United States

RECRUITING

MeSH Terms

Conditions

Renal Insufficiency, ChronicDiabetes MellitusRenal InsufficiencyRejection, PsychologyProteinuria

Interventions

empagliflozin

Condition Hierarchy (Ancestors)

Kidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesSocial BehaviorBehaviorUrination DisordersUrological ManifestationsSigns and Symptoms

Study Officials

  • Roslyn B Mannon, MD

    Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Roslyn B Mannon, MD

CONTACT

Ramesh K Ramalingam

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Model Details: Prospective Observational Cohort Study
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 22, 2023

First Posted

August 28, 2023

Study Start

April 5, 2024

Primary Completion (Estimated)

March 31, 2030

Study Completion (Estimated)

March 31, 2030

Last Updated

April 21, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Locations