Description
Inclusion Criteria:
- INCLUSION CRITERIA
- 1. Adult (\>18 years of age) male and female recipients (all races and ethnicities)
- 2. Subject must be able to understand and provide consent
- 3. Recipient of a primary or secondary kidney transplant at least 3 months or longer since transplant
- 4. Subject must have a diagnosis of Type 2 Diabetes Mellitus or post-transplant diabetes mellitus (PTDM) 2DM or PTDM
- 5. Subject must be able to travel to and from VAMC for care and monitoring
- 6. Subject must have kidney function measured by CKD epi eGFR 30 mL/min/1.73m2 to \< 45ml/min/1.73m2 or CKD epi eGFR 45 mL/min/1.73m2 to 90ml/min/1.73m2 with urinary albumin:creatinine ratio 200 mg/g (or protein:creatinine 300 mg/g).
Exclusion Criteria:
- EXCLUSION CRITERIA
- 1. Inability or unwillingness of a participant to give written informed consent or comply with study protocol
- 2. History of prior pancreas transplant
- 3. CKD epi eGFR\< 30 mL/min/1.73m2 with 5mL/min/1.73m2 fall per year
- 4. Uncontrolled type 2 diabetes mellitus with most recent A1C\>12%
- 5. History of \>2 urinary tract infections per year or UTIs requiring admission in the last year, or urosepsis in the last year.
- 6. Use of SGLT2i within 90 days
- 7. Documented allergy to SGLT2i
- 8. History of Type I diabetes mellitus
- 9. History of diabetic ketoacidosis
- 10. Indwelling foley catheter or urinary diversion
- 11. Acute rejection in the prior 3 months
- 12. Acute MACE event within 3 months of the study
- 13. Severe congestive heart failure (NYHA functional class III or higher)
- 14. Active mucocutaneous mycotic infection of the groin or external genitalia.
- 15. History of amputation due to peripheral vascular disease and/or diabetic foot ulcers within prior year
- 16. History of malignancy except non-melanoma skin cancer within 5 years of screening
- 17. Known active current viral, fungal, mycobacterial, or other infections (including, but not limited to tuberculosis and atypical mycobacterial disease)
- 18. HIV infected subjects, including those who are well controlled on anti-retrovirals
- 19. Positive Hep B PCR
- 20. Hepatitis C virus antibody positive (HCVAb+) subjects who have failed to demonstrate sustained viral remission for more than 12 weeks (after anti-viral treatment)
- 21. Active pregnancy in a female transplant recipient
Ages Eligible for Study:
19 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
No