The following is a summary of “Possible Advantage of Glucagon-Like Peptide 1 Receptor Agonists for Kidney Transplant Recipients With Type 2 Diabetes,” published in the October 2023 issue of Endocrinology by Sato, et al.
Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) have shown potential in enhancing native kidney function. For a retrospective cohort study, researchers sought to explore the potential protective effects of GLP-1 RAs on kidney graft function following successful kidney transplantation (KTX).
The study included all KTX recipients (KTRs) with type 2 diabetes at the institution, tracked from 1 month post-transplantation for at least 24 months until December 31, 2020. The investigation focused on the associations between GLP-1 RAs and other antidiabetic medications (non–GLP-1 RAs) and the risk of sustained estimated glomerular filtration rate (eGFR) reduction (40% reduction compared with baseline for 4 months) in KTRs with type 2 diabetes. Propensity scores for initiating GLP-1 RAs vs. non–GLP-1 RAs were calculated based on baseline covariates using logistic regression. The inverse probability of the treatment-weighted odds ratio was estimated to control for baseline confounding variables, with sodium-glucose cotransporter 2 inhibitor use considered a competing event. The primary outcome was sustained eGFR reduction of at least 40% from baseline for 4 months post-transplantation.
Among 73 GLP-1 RA users and 73 non–GLP-1 RA users, 6 and 1 patient(s), respectively, experienced sustained eGFR reduction. GLP-1 RA use post-KTX was associated with a reduced risk of sustained eGFR reduction.
GLP-1 RAs demonstrated a lower eGFR reduction than non–GLP-1 RAs, suggesting a potential contribution to improved kidney graft survival post-KTX.