Why the study?
Comprehensive evaluations of the impact of GLP-1 RAs on kidney and cardiovascular outcomes in patients with type 2 diabetes and advanced chronic kidney disease were lacking.
Does GLP-1 receptor agonist therapy reduce the incidence of dialysis initiation and major adverse cardiovascular events in patients with type 2 diabetes and advanced CKD?
Population
51 910 matched pairs with T2DM, aged >=18 years, and eGFR <=45 mL/min/1.73 m2
Comparison
GLP-1 RA users vs nonusers
Design
Retrospective cohort study with a new user design and propensity score matching
Key result
GLP-1 RA use in patients with T2DM and advanced CKD was associated with a significantly lower incidence of dialysis initiation (HR 0.89; 95% CI 0.85-0.93) and MACE (HR 0.92; 95% CI 0.88-0.95).
Authors
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Supports potential benefit of GLP-1 RAs in advanced CKD; hypothesis-generating and requires RCT confirmation.
Cohort (n=103,820)
Yes
Does GLP-1 receptor agonist therapy reduce the incidence of dialysis initiation and major adverse cardiovascular events in patients with type 2 diabetes and advanced CKD?
Effect estimate: HR 0.89 (dialysis); HR 0.92 (MACE) (95% CI 0.85-0.93 (dialysis); 0.88-0.95 (MACE))
In a real-world cohort of patients with type 2 diabetes and advanced CKD, GLP-1 receptor agonist use was associated with significantly lower risks of dialysis initiation, major adverse cardiovascular events, and mortality.
Hsiao et al. (2025) conducted a cohort in Type 2 diabetes mellitus and advanced chronic kidney disease (n=103,820). GLP-1 receptor agonists vs. GLP-1 RA nonusers was evaluated on Dialysis initiation and major adverse cardiovascular events (HR 0.89 (dialysis); HR 0.92 (MACE), 95% CI 0.85-0.93 (dialysis); 0.88-0.95 (MACE)). GLP-1 RA use in patients with T2DM and advanced CKD was associated with a significantly lower incidence of dialysis initiation (HR 0.89; 95% CI 0.85-0.93) and MACE (HR 0.92; 95% CI 0.88-0.95).