Felix, Nicole, Gauza, Mateus M., Bittar, Vinicius, Nogueira, Alleh, Costa, Thomaz A., Godoi, Amanda, Araújo de Lucena, Larissa, Ribeiro Gonçalves, Ocílio, Santos Pinto, Luís Cláudio, Tramujas, Lucas, Moura-Neto, José A. and Guimarães, Maria Gabriela
2025.
Cardiovascular and kidney outcomes of glucagon-like peptide 1 receptor agonist therapy in type 2 diabetes mellitus and chronic kidney disease: a systematic review and meta-analysis.
CardioRenal Medicine
15
(1)
, pp. 98-107.
10.1159/000543149
|
Preview |
PDF
- Published Version
Available under License Creative Commons Attribution Non-commercial. Download (939kB) | Preview |
Abstract
Introduction: The effects of glucagon-like peptide 1 receptor agonists (GLP-1 RA) in patients with diabetes and established chronic kidney disease (CKD) remain unclear. Methods: We systematically searched PubMed, Embase, and Cochrane Library from inception to May 2024 for randomized controlled trials (RCTs) and respective post hoc studies comparing GLP-1 RAs versus placebo in patients with type 2 diabetes mellitus (T2DM) and established CKD (as per study definition or otherwise defined as having an estimated glomerular filtration rate less than 60 mL/min/1.73 m2 and/or urine albumin-to-creatinine ratio more than 30 mg/g). We applied a random-effects model to pool risk ratios (RRs), hazard ratios (HRs), and 95% confidence intervals (CIs). Results: We included 10 RCTs and post hoc analyses comprising 18,042 patients, of whom 9,164 (50.8%) were treated with GLP-1 RAs. There were significantly lower rates of major adverse kidney events (RR 0.82; 95% CI: 0.74–0.90; p < 0.001; high certainty) and a slightly lower incidence of all-cause mortality (HR 0.84; 95% CI: 0.71–1.00; p = 0.046; moderate certainty) with the use of GLP-1 RAs relative to placebo. This kidney protection remained consistent in patients with stage 3b CKD (RR 0.78; 95% CI: 0.65–0.94; p = 0.009; high certainty). No significant differences were observed in major adverse cardiovascular events (HR 0.89; 95% CI: 0.78–1.02; p = 0.090; low certainty) or cardiovascular mortality (HR 0.80; 95% CI: 0.60–1.09; p = 0.155; very low certainty), possibly due to a lack of statistical power. Conclusion: GLP-1 RAs were tied to a lower incidence of all-cause mortality and major adverse kidney events in patients with T2DM and established CKD.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Medicine Research Institutes & Centres > Centre for Trials Research (CNTRR) |
| Publisher: | Karger Publishers |
| ISSN: | 1664-3828 |
| Date of First Compliant Deposit: | 21 March 2025 |
| Date of Acceptance: | 11 December 2024 |
| Last Modified: | 24 Mar 2025 10:48 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/177081 |
Actions (repository staff only)
 |
Edit Item |
Altmetric
Altmetric