Glucagon-Like Peptide-1 Receptor Agonist Use in People Living with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Narrative Review of the Key Evidence with Practical Considerations

Feb 17, 2022Diabetes therapy : research, treatment and education of diabetes and related disorders

Use of Glucagon-Like Peptide-1 Receptor Agonists in People with Type 2 Diabetes and Chronic Kidney Disease: Key Evidence and Practical Points

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Abstract

(GLP-1 RAs) may improve kidney function in individuals with type 2 diabetes and .

GLP-1 RAs are associated with significant weight loss and a low risk of hypoglycemia.
Clinical studies suggest that GLP-1 RAs may reduce major cardiovascular events.
Evidence indicates that GLP-1 RAs are safe and tolerable for patients with compromised renal function.
Some studies suggest potential renoprotective properties of GLP-1 RAs in patients with type 2 diabetes and chronic kidney disease.
Despite their benefits, the use of GLP-1 RAs in this patient population remains uncommon.

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(GLP-1 RAs) are incretin-mimetic agents that are effective adjuncts in the treatment of diabetes. This class of medications is also associated with promoting weight loss and a low risk of hypoglycemia, and some have been shown to be associated with a significant reduction of major cardiovascular events. Mounting evidence suggests that GLP-1 RAs have benefits beyond reducing blood glucose that include improving kidney function in people living with type 2 diabetes mellitus (T2DM) and (CKD), a common microvascular complication of T2DM. Several large clinical studies, the majority of which are cardiovascular outcome trials, indicate that GLP-1 RA therapy is safe and tolerable for people living with T2DM and compromised renal function, and also suggest that GLP-1 RAs may have renoprotective properties. Although evidence from clinical trials has shown GLP-1 RAs to be safe and efficacious in people living with T2DM and renal impairment, their use is uncommon in this patient population. With continuing developments in the field of GLP-1 RA therapy, it is important for physicians to understand the benefits and practical use of GLP-1 RAs, as well as the clinical evidence, in order to achieve positive patient outcomes. Here, we review evidence on GLP-1 RA use in people living with T2DM and CKD and summarize renal outcomes from clinical studies. We provide practical considerations for GLP-1 RA use to provide an added benefit to guide treatment in this high-risk patient population.

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Glucagon-Like Peptide-1 Receptor Agonist Use in People Living with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Narrative Review of the Key Evidence with Practical Considerations

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