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Kidney Outcomes With Glucagon‐Like Peptide‐1 Receptor Agonists Versus Other Glucose‐Lowering Agents in People With Type 2 Diabetes: A Systematic Review and Meta‐Analysis of Real‐World Data
Kidney effects of GLP-1 receptor drugs compared to other diabetes treatments in people with type 2 diabetes
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Abstract
Analysis of 1,601,389 patients with type 2 diabetes indicates that initiation of GLP-1 receptor agonists is associated with varying kidney outcomes compared to other glucose-lowering agents.
- GLP-1 receptor agonist initiators may have higher risks for and kidney-related hospitalizations compared to those starting sodium-glucose cotransporter-2 inhibitors.
- Risks for a ≥ 40% reduction in kidney function are greater for GLP-1 RA initiators compared to sodium-glucose cotransporter-2 inhibitors.
- Compared to dipeptidyl-peptidase 4 inhibitors, GLP-1 RA initiation is associated with lower risks for experiencing a ≥ 50% reduction in kidney function and kidney-related hospitalizations.
- Initiation of GLP-1 RA is linked to a lower risk of compared to dipeptidyl-peptidase 4 inhibitors and sulfonylureas.
- GLP-1 RA initiation may reduce the risk of albuminuria progression compared to basal insulin, although the evidence regarding end-stage kidney disease risk is inconsistent.
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Key numbers
1.12
Increase in Risk
Hazard Ratio (HR) for among GLP-1 RA vs. SGLT2i initiators
0.70
Decrease in Risk
Hazard Ratio (HR) for among GLP-1 RA vs. DPP4i initiators
1.66
Increase in Kidney-Related Hospitalizations
Hazard Ratio (HR) for kidney-related hospitalizations among GLP-1 RA vs. SGLT2i initiators