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Impact of GLP-1 RAs on Cardiorenal Outcomes and Mortality in People With Type 2 Diabetes and Acute Kidney Disease
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- This longitudinal study investigated the association of GLP-1 receptor agonist (GLP-1 RA) use with the risks of mortality, major adverse cardiovascular events (MACE), and major adverse kidney events (MAKE) in individuals with type 2 diabetes and acute kidney disease using global data from the TriNetX database between 2002 and 2022. At a median follow-up duration of 2.3 years, GLP-1 RA users exhibited reduced risks of mortality (adjusted HR, 0.57), MACE (adjusted HR, 0.88), and MAKE (adjusted HR, 0.73).
- These findings suggest the potential beneficial role of GLP-1 RAs in reducing the risks of mortality, MACE, and MAKE in patients with type 2 diabetes following severe acute kidney injury.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPrevious studies have explored the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in reducing cardiovascular events in type 2 diabetes. Here we show that GLP-1 RAs are associated with lower risks of mortality, major cardiovascular events (MACEs), and major adverse kidney events (MAKEs) in type 2 diabetes patients with acute kidney disease (AKD). Utilizing global data from the TriNetX database (2002/09/01-2022/12/01) and propensity score matching, we compare 7511 GLP-1 RAs users to non-users among 165,860 AKD patients. The most common causes of AKI are sepsis (55.2%) and cardiorenal syndrome (34.2%). After a median follow-up of 2.3 years, GLP-1 RAs users exhibit reduced risks of mortality (adjusted hazard ratio [aHR]: 0.57), MACEs (aHR: 0.88), and MAKEs (aHR: 0.73). External validation in a multicenter dataset of 1245 type 2 diabetes patients with AKD supports the favorable outcomes. These results emphasize the potential of GLP-1 RAs in individualized treatment for this population.
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GLP-1 receptor agonists' impact on cardio-renal outcomes and mortality in T2D with acute kidney disease
Nat Commun 2024 Jul 13;15(1)5912, HC Pan, JY Chen, HY Chen, FY Yeh, CY Sun, TT Huang, VC WuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
GLP-1–receptor agonists, a growing list of remarkable benefits
Acute kidney injury (AKI) is a common occurrence in hospitalized patients. For years, observational data have shown that AKI can have long-lasting effects on the kidneys, heart, and overall mortality, and this includes circumstances in which the glomerular filtration rate makes a full recovery.1 More recently, the use of techniques such as single-cell transcriptomics has begun to unravel plausible cellular disrepair mechanisms that may connect these long-term outcomes to distant AKI events.2 With a deepening understanding of these new mechanisms, we have new ideas about testing therapeutic strategies to prevent kidney, cardiac, and mortality events after AKI.
In the study by Heng-Chih et al, the authors analyze data from a large database to compare outcomes in patients with type 2 diabetes and hospital-associated AKI who are receiving GLP-1 receptor agonists versus those who are not. The study finds that, at a median follow-up period of 2.3 years, there were significantly lower risks for mortality (aHR, 0.57), major cardiovascular events (aHR, 0.88), and major kidney events (aHR, 0.73). The etiologies of AKI were heterogeneous. These findings were consistent across multiple predefined subgroups and when various sensitivity tests were employed.
The findings of this study add to the recent reports showing kidney and cardiac protection from GLP1-receptor agonists.3,4 The findings reported by Heng-Chih et al are unique in that they suggest that this class of drugs impacts outcomes specifically in the setting of AKI. This adds to their growing list of remarkable benefits; however, more robust study design is needed to further understand if there truly are protective mechanisms unique to cellular disrepair mechanisms recently described in AKI, or rather is this a more general effect similar to that observed in previous populations with cardiovascular disease and chronic kidney disease.
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