GLP-1RAs significantly reduced urine protein:creatinine ratio (SMD -0.47; 95% CI -0.77 to -0.18) and haemoglobin A1c levels (MD -0.85%) in adult kidney transplant recipients.
Meta-Analysis
Do GLP-1RAs improve glycaemic control, weight, and kidney graft function safely in adult kidney transplant recipients?
GLP-1RAs effectively reduce proteinuria, improve glycaemic control, and support weight loss in kidney transplant recipients without affecting tacrolimus levels, though gastrointestinal side effects are common.
Standardized Mean Difference: -0.47 (95% CI -0.77–-0.18)
Background: Evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RAs) in kidney transplant recipients (KTRs) remains scarce. This systematic review and meta-analysis aims to evaluate the safety and efficacy of GLP-1RAs in this population. Methods: A comprehensive literature search was conducted in the MEDLINE, Embase and Cochrane databases from inception through May 2023. Clinical trials and observational studies that reported on the safety or efficacy outcomes of GLP-1RAs in adult KTRs were included. Kidney graft function, glycaemic and metabolic parameters, weight, cardiovascular outcomes and adverse events were evaluated. Outcome measures used for analysis included pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes and standardized mean difference (SMD) or mean difference (MD) with 95% CI for continuous outcomes. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD 42023426190). Results: (95% CI -0.64-0.50)] or creatinine SMD -0.08 mg/dl (95% CI -0.44-0.28), they were associated with a significant decrease in urine protein:creatinine ratio SMD -0.47 (95% CI -0.77 to -0.18) and haemoglobin A1c levels MD -0.85% (95% CI -1.41 to -0.28). Total daily insulin dose, weight and body mass index also decreased significantly. Tacrolimus levels remained stable MD -0.43 ng/ml (95% CI -0.99 to 0.13). Side effects were primarily nausea and vomiting (17.6%), diarrhoea (7.6%) and injection site pain (5.4%). Conclusions: GLP-1RAs are effective in reducing proteinuria, improving glycaemic control and supporting weight loss in KTRs, without altering tacrolimus levels. Gastrointestinal symptoms are the main side effects.
Krisanapan et al. (Thu,) conducted a meta-analysis in Kidney transplant recipients. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) was evaluated on Urine protein:creatinine ratio (SMD -0.47, 95% CI -0.77 to -0.18). GLP-1RAs significantly reduced urine protein:creatinine ratio (SMD -0.47; 95% CI -0.77 to -0.18) and haemoglobin A1c levels (MD -0.85%) in adult kidney transplant recipients.