Abstract
BACKGROUND: To determine whether glucagon-like peptide 1 receptor agonists (GLP-1RAs) have cardiovascular and renal protective effects in patients with advanced diabetic kidney disease (DKD) with an estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m 2.
METHODS: In this cohort study, patients with type 2 diabetes mellitus and eGFR < 30 mL/min per 1.73 m 2 with a first prescription for GLP-1RAs or dipeptidyl peptidase 4 inhibitors (DPP-4is) from 2012 to 2021 (n = 125,392) were enrolled. A Cox proportional hazard model was used to assess the cardiorenal protective effects between the GLP-1RA and DDP-4i groups.
RESULTS: A total of 8922 participants [mean (SD) age 68.4 (11.5) years; 4516 (50.6%) males; GLP-1RAs, n = 759; DPP-4is, n = 8163] were eligible for this study. During a mean follow-up of 2.1 years, 78 (13%) and 204 (13.8%) patients developed composite cardiovascular events in the GLP-1RA and DPP-4i groups, respectively [hazard ratio (HR) 0.88, 95% confidence interval CI 0.68-1.13]. Composite kidney events were reported in 134 (38.2%) and 393 (44.2%) patients in the GLP-1RA and DPP-4i groups, respectively (subdistribution HR 0.72, 95% CI 0.56-0.93).
CONCLUSIONS: GLP-1RAs had a neutral effect on the composite cardiovascular outcomes but reduced composite kidney events in the patients with advanced DKD compared with DPP-4is.
Original language | English |
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Article number | 60 |
Pages (from-to) | 60 |
Journal | Cardiovascular Diabetology |
Volume | 22 |
Issue number | 1 |
DOIs | |
State | Published - 17 03 2023 |
Bibliographical note
© 2023. The Author(s).Keywords
- Advanced diabetic kidney disease
- CV outcomes
- GLP-1RA
- Renal outcomes
- Glucagon-Like Peptide 1
- Humans
- Male
- Diabetes Mellitus, Type 2/complications
- Kidney
- Hypoglycemic Agents
- Glucagon-Like Peptide-1 Receptor/agonists
- Dipeptidyl-Peptidase IV Inhibitors
- Diabetic Nephropathies/diagnosis
- Female
- Aged
- Cardiovascular Diseases/diagnosis
- Cohort Studies