Mortality and cardiovascular events in diabetes mellitus patients at dialysis initiation treated with glucagon-like peptide-1 receptor agonists
An erratum to this article was published (Cardiovasc Diabetol, 14 Oct 2024 ↗)
Authors' conclusion
Given to the limitations of this observational study, use of GLP-1RAs at the onset of dialysis was associated with a decreased risk of MACE, MAKE, and all-cause mortality. These findings show the lack of harm associated with the use of GLP-1RAs in diabetic patients at the initiation of acute dialysis.
Study context
- Population
- T2D patients initializing dialysis, TriNetX global database; GLP-1 RA users mean age 59.3 years, 55.4% malepropensity-matched
- Participants
- 1,682 patients
- Exposure
- GLP-1 RA vs long-acting insulin at dialysis initiation
- Outcome
- All-cause mortality, 4-point MACE and major adverse kidney events (MAKE)
- Follow-up
- Median 1.4 years
Methodological detailspropensity-score matched, TriNetX global database
- Propensity-score matched
- TriNetX global database
Main finding
As reported in the abstract
Hazard ratio (mortality)
0.63
P < 0.001
GLP-1RAs
Hazard ratio (4p-MACE)
0.65
P < 0.001
GLP-1RAs
Hazard ratio (major adverse kidney events (MAKE))
0.75
P < 0.001
GLP-1RAs
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| New GLP-1 RA use at dialysis commencementGLP-1RAs vs LAI · lower risk of MACE | P = 0.047 |
| New GLP-1 RA use at dialysis commencementGLP-1RAs vs LAI · lower risk of MAKE | P = 0.004 |
Subgroups
- Association particularly notable in long-acting GLP-1 RA users, higher BMI, lower HbA1c and eGFR > 15 ml/min/1.73m2
Patients discontinuing acute dialysis or long-term GLP-1 RA users
- GLP-1 RA use associated with lower risk of mortality, 4p-MACE and MAKE
Original publication
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