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논문분류	춘계학술대회 초록집
제목	SGLT2 Inhibitors and the Risk of Urinary Tract Infections in Kidney Transplant Recipients: A Propensity Score Matched Multicenter Cohort Study
저자	Jung-Hoon Han
출판정보	2026; 2026(1):
키워드	SGLT2i, Kidney Transplantation Recipients, UTI risk
초록	Objectives: The renal and cardiac benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with chronic kidney disease have raised interest in their use among kidney transplant recipients (KTRs). However, concerns regarding urinary tract infections (UTIs) remain a major barrier to prescribing SGLT2i in KTRs. This study aimed to evaluate the association between the incidence of UTI and SGLT2i use in KTRs. Methods: This multicenter retrospective cohort study included 1,966 KTRs, of whom 179 were prescribed SGLT2i. Baseline characteristics and infection outcomes were compared between SGLT2i users and non-users. UTI incidence rates were calculated per person-year, and negative binomial analysis was used to compare the rates. Propensity score matching (PSM) was performed to reduce baseline imbalances, and Anderson-Gill Cox proportional hazards modeling was applied to assess the risk of recurrent UTI events. Results: Before matching, the overall UTI incidence rates per person-year were comparable between SGLT2i users and non-users (0.294 vs. 0.311, P=0.251). Bacterial infection incidence was also similar (0.270 vs. 0.296, P=0.110), whereas fungal infections were more frequent in SGLT2i users (0.025 vs. 0.016, P=0.018). Among the 112 SGLT2i users who experienced infections, the incidence rate decreased after initiation of SGLT2i therapy (0.332 to 0.085 per person-year). After 1:3 PSM (n=702), overall UTI incidence remained similar between groups (0.294 vs. 0.305, P=0.123; Table 1), however, bacterial infection incidence was significantly lower in the SGLT2i users (0.270 vs. 0.295, P=0.033; Table 1). Fungal infections showed a trend toward lower rates in the SGLT2i users (0.025 vs. 0.057, P=0.071; Table 1). In table 2, Anderson-Gill Cox regression revealed no significant association between SGLT2i use and recurrent UTI risk (hazard ratio 1.01, 95% confidence interval 0.78–1.36, P=0.69). Conclusion: SGLT2i use in KTRs was not associated with an increased risk of UTI. These findings suggest the cautious consideration of SGLT2i in clinical practice for KTRs.
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