Chronic kidney outcomes associated with GLP-1 receptor agonists versus long-acting insulins among type 2 diabetes patients requiring intensive glycemic control: a nationwide cohort study
Main finding · Composite renal outcomeResult — go to the resultSubdistribution hazard ratio 0.39 95% CI 0.30–0.51Authors' conclusion
Using GLP-1RAs versus LAIs was associated with kidney benefits in T2D patients requiring intensive glycemic control and potentially at high risk of kidney progression. GLP-1RAs should be prioritized to patients with CVDs or adherence to prior oral GLAs to maximize kidney benefits.
Study context
- Population
- T2D patients with poor glycemic control requiring injectable glucose-lowering agents, 2013–2018, Taiwan7,279 matched pairs
- Exposure
- GLP-1 RAs vs long-acting insulins
- Outcome
- Composite renal outcome:
- Renal insufficiency (eGFR < 15 mL/min/1.73 m²)
- Dialysis-dependent ESRD
- Renal death
- Follow-up
- Until death or 12/31/2019
Methodological detailspropensity-score matched, intention-to-treat, Taiwan National Health Insurance Research Database
- Propensity-score matched
- Intention-to-treat
- Taiwan National Health Insurance Research Database
Main finding
Composite renal outcome
Subdistribution hazard ratio
0.39
95% CI 0.30–0.51
GLP-1RAsvs LAIs
subdistribution HR 0.39 (95% CI 0.30–0.51)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Subdistribution HR (95% CI) | |
|---|---|---|
| Renal insufficiencyGLP-1RAsvs LAIs | 0.43 (0.32–0.57) | |
| Dialysis-dependent ESRDGLP-1RAsvs LAIs | 0.29 (0.20–0.43) | |
| Renal deathGLP-1RAsvs LAIs | 0.28 (0.15–0.51) | |
| 0.10.31310Subdistribution hazard ratio (log scale) |
Sensitivity analyses and effect modification
- Sensitivity analysis results were consistent with the primary findings
- CVD history and medication possession ratio of prior oral glucose-lowering agents (GLAs) modified GLP-1RA-associated kidney outcomes
Original publication
Chronic kidney outcomes associated with GLP-1 receptor agonists versus long-acting insulins among type 2 diabetes patients requiring intensive glycemic control: a nationwide cohort study. Cardiovasc Diabetol. Published 4 October 2023. doi:10.
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