Cardiorenal protective effects of glucagon-like peptide-1 receptor agonists in chronic kidney disease: a systematic review and meta-analysis.
Yuqi Wang, Luda Feng, Yajing Wang et al.
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In 30 seconds
This systematic review and meta-analysis assessed cardiorenal outcomes and adverse effects of GLP-1 receptor agonists in people with chronic kidney disease. It included nine randomized controlled trials involving 21,717 patients, the vast majority with type 2 diabetes. Compared with control, GLP-1 receptor agonist treatment was associated with lower risks of major adverse kidney events (RR, 0.84; 95% CI, 0.76-0.94), major adverse cardiac and cerebrovascular events (RR, 0.84; 95% CI, 0.72-0.97), and all-cause mortality (RR, 0.83; 95% CI, 0.76-0.90), alongside increased gastrointestinal events.
Key findings
- Major adverse kidney events were less frequent with GLP-1 receptor agonists (RR, 0.84; 95% CI, 0.76-0.94).
- Major adverse cardiac and cerebrovascular events were reduced (RR, 0.84; 95% CI, 0.72-0.97), as was all-cause mortality (RR, 0.83; 95% CI, 0.76-0.90).
- Albuminuria was lower with treatment (SMD, -1.22; 95% CI, -1.53 - 0.90).
- Gastrointestinal events were more common, including nausea (RR, 4.14; 95% CI, 2.70-6.33) and vomiting (RR, 3.05; 95% CI, 1.88-4.97).
Why it matters
The pooled trial evidence suggests potential kidney and cardiovascular benefits of GLP-1 receptor agonists in CKD, while also highlighting gastrointestinal adverse effects. These findings are most directly relevant to populations resembling the included trials, in which most participants had type 2 diabetes, and help frame the balance of outcomes assessed in this group.
What to keep in mind
The included population was predominantly patients with type 2 diabetes, limiting how directly the findings apply to people with CKD without diabetes.