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- Title
The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease.
- Authors
Lin, Yuan; Wang, Te-Hsiung; Tsai, Ming-Lung; Wu, Victor Chien-Chia; Tseng, Chin-Ju; Lin, Ming-Shyan; Li, Yan-Rong; Chang, Chih-Hsiang; Chou, Tien-Shin; Tsai, Tzu-Hsien; Yang, Ning-I; Hung, Ming-Jui; Chen, Tien-Hsing
- 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 m2. Methods: In this cohort study, patients with type 2 diabetes mellitus and eGFR < 30 mL/min per 1.73 m2 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.
- Subjects
GLUCAGON-like peptide-1 agonists; GLUCAGON-like peptide 1; DIABETIC nephropathies; PEPTIDE receptors; TYPE 2 diabetes; PEOPLE with diabetes
- Publication
Cardiovascular Diabetology, 2023, Vol 22, Issue 1, p1
- ISSN
1475-2840
- Publication type
Article
- DOI
10.1186/s12933-023-01793-9