The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease

Yuan Lin, Te Hsiung Wang, Ming Lung Tsai, Victor Chien Chia Wu, Chin Ju Tseng, Ming Shyan Lin, Yan Rong Li, Chih Hsiang Chang, Tien Shin Chou, Tzu Hsien Tsai, Ning I. Yang, Ming Jui Hung, Tien Hsing Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

10 Scopus citations

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 languageEnglish
Article number60
Pages (from-to)60
JournalCardiovascular Diabetology
Volume22
Issue number1
DOIs
StatePublished - 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

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