Safety and Efficacy of Glucagon Like Peptide-1 Receptor Agonism-Based Therapies in End-Stage Renal Disease: A Systematic Review and Meta-Analysis
Authors' conclusion
GLP1RA-BT specifically semaglutide, may be considered for use in ESRD. The results are primarily hypothesis generating
Study context
- Population
- People with end-stage renal disease (GFR<15 ml/min/1.73 m² or on renal replacement therapy); 91.5% on renal replacement therapy; baseline weight 97.7 ± 23.8 kg, body mass index (BMI) 34.4 ± 6.8kg/m², HbA1c 7.26 ± 1.53%
- Participants
- 388 people19 studies
- Comparison
- GLP-1 RA-based therapies in end stage renal disease (ESRD)
- Semaglutiden = 266
- Liraglutiden = 66
- Dulaglutiden = 47
- Tirzepatiden = 9
- Outcome
- Mean reduction in body weight from baseline following GLP-1 RA-based therapy
Pooled result
As reported in the abstract
Body weight change from baseline · 3, 6 and 12 months
- Semaglutide, 3 months: weight change kg
- −3.09 (95% CI −5.95, −0.24; I2 = 58.1%)
- Semaglutide, 6 months: weight change kg
- −3.68 (95% CI −5.71, −1.65; I2 = 0.0%)
- Semaglutide, 12 months: weight change kg
- −7.00 (95% CI −11.38, −2.61; I2 = 79.2%)
- Liraglutide, 3 months: weight change kg
- −2.24 (95% CI −7.73, 3.26; I2 = 0.0%)
- Liraglutide, 6 months: weight change kg
- −4.50 (95% CI −11.26, 2.27; I2 = 0.0%)
Further pooled results
BMI change with semaglutide · 3, 6 and 12 months
- 3 months, kg/m²
- −1.42 (95% CI −2.92, 0.09; I2 = 0.0%)
- 6 months, kg/m²
- −1.26 (95% CI −1.90, −0.62; I2 = 0.0%)
- 12 months, kg/m²
- −3.09 (95% CI −5.28, −0.89; I2 = 95.9%)
HbA1c change with semaglutide · 6 and 12 months
- 6 months
- −0.50% (95% CI −1.20, 0.20; I2 = 0.0%)
- 12 months
- −0.75% (95% CI −1.07, −0.43; I2 = 61.6%)
Safety
Adverse events with semaglutide
- Total adverse events (AEs)
- 44% (95% CI 24%, 66%; I2 = 58.3%)
- Gastrointestinal AEs
- 39% (95% CI 25%, 55%; I2 = 48.8%)
- Nausea
- 36% (95% CI 3%, 91%; I2 = 73.6%)
- Vomiting
- 13% (95% CI 2%, 53%; I2 = 0.0%)
- Hypoglycaemia
- 9% (95% CI 0%, 82%; I2 = 0.0%)
- Discontinuation due to AEs
- 9% (95% CI 4%, 20%; I2 = 60.3%)
Original publication
Safety and Efficacy of Glucagon Like Peptide-1 Receptor Agonism-Based Therapies in End-Stage Renal Disease: A Systematic Review and Meta-Analysis. Endocr Pract. Published 4 August 2026. doi:10.
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