Keywords
Chronic Kidney Disease
Type 2 diabetes
Effects
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Abstract
Objective: To analyze the effects of GLP-1 analogues on the progression of chronic kidney disease (CKD) in patients with type 2 diabetes, their benefits and risks associated with their use. Methods: Integrative literature review in the PubMed Central (PMC) database, using the search strategy: ((GLP-1RA) OR (Glucagon-like peptide-1 receptor agonists) OR (GLP-1)) AND ((Chronic Kidney Disease) OR (CKD)) from 2019 to 2024. After the initial search, 585 studies were identified and subjected to selection criteria. After applying inclusion and exclusion criteria, 18 articles were selected to compose this study. Results: The impact of GLP-1 analogues on renal function and CKD progression in patients with type 2 diabetes was analyzed, exploring the mechanisms of renal protection, assessing potential risks at different stages of the disease. Final considerations: Studies suggest a reduction in albuminuria and a delay in the decline in the Glomerular Filtration Rate (GFR), thus promoting a more favorable prognosis. The use of GLP-1 analogues in CKD patients is beneficial in renal protection; however, it still requires special attention in advanced stages of the disease to avoid possible complications.
References
ALICIC RZ e NEUMILLER JJ. Incretin Therapies for Patients with Type 2 Diabetes and Chronic Kidney Disease. Journal Clinical Medicine, 2023; 13(1): 201.
BHAILÍS ÁM, et al. Diabetic kidney disease: update on clinical management and non-glycaemic effects of newer medications for type 2 diabetes. Therapeutic Advances in Endocrinology and Metabolism, 2021; 12: 1-15.
BOMHOL T, et al. The Glycemic Effect of Liraglutide Evaluated by Continuous Glucose Monitoring in Persons with Type 2 Diabetes Receiving Dialysis. Nephron, 2021; 145(1): 27-34.
BUENO BA, et al. Semaglutide in type 2 diabetes with chronic kidney disease at high risk of progression—real-world clinical practice. Clinical Kidney Journal, 2022; 15(8): 1593–1600.
CHEN JJ, et al. Association of Glucagon-Like Peptide-1 Receptor Agonist vs Dipeptidyl Peptidase-4 Inhibitor: Use With Mortality Among Patients With Type 2 Diabetes and Advanced Chronic Kidney Disease. JAMA Network Open, 2022; 5(3): 221169-221169.
COLHOUN HM, et al. Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial. Nature Medicine, 2024; 30: 2058-2066.
DE LUCAS MDG, et al. Influence of chronic kidney disease and its severity on the efficacy of semaglutide in type 2 diabetes patients: a multicenter real-world study. Frontiers in Endocrinology, 2023; 14: 1240279.
GARCIA LP, et al. Progress in the management of patients with diabetes and chronic kidney disease. Current Opinion in Nephrology and Hypertension, 2022; 31(5): 456-463.
KRISANAPAN P, et al. Safety and efficacy of GLP-1 receptor agonists in type 2 diabetes mellitus with advanced and end-stage kidney disease: a systematic review and meta-analysis. Diseases, 2024; 12(1): 14.
LI X, et al. Effect of glucagon-like peptide 1 receptor agonists on the renal protection in patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes & Metabolism, 2022; 48(5): 101366.
LI Y, et al. Comparison of efficacy and safety of three novel hypoglycemic agents in patients with severe diabetic kidney disease: A systematic review and network meta-analysis of randomized controlled trials. Frontiers in Endocrinology, 2022; 13: 1003263.
MANN JFE, et al. Potential Kidney protection with liraglutide and semaglutide: exploratory mediation analysis. Diabetes, Obesity and Metabolism, 2021; 23(9): 2058-2066.
MAYNE KJ, et al. Detecting and managing the patient with chronic kidney disease in primary care: A review of the latest guidelines. Diabetes, Obesity and Metabolism, 2024; 1(1): 1-12.
SCHECHTER M, et al. Kidney function loss and albuminuria progression with GLP-1 receptor agonists versus basal insulin in patients with type 2 diabete: real-world evidence. Cardiovascular Diabetology, 2023; 22(1): 126.
SCHOLTEN BJV, et al. The potential of GLP-1 receptor agonists in type 2 diabetes and chronic disease: from randomised trials to clinical pratice. Therapeutic Advances in Endocrinology and Metabolism, 2022; 13: 1-14.
SHAMAN AM, et al. Effect of the Glucagon-Like Peptide-1 Receptor Agonists Semaglutide and Liraglutide on Kidney Outcomes in Patients With Type 2 Diabetes: Pooled Analysis of SUSTAIN 6 and LEADER. Circulation, 2022; 145(8): 575-585.
SLOAN LA. Review of glucagon‐like peptide‐1 receptor agonists for the treatment of type 2 diabetes mellitus in patients with chronic kidney disease and their renal effects. Journal of Diabetes, 2019; 11(12): 938-948.
SUZUKI Y, et al. Comparison of estimated glomerular filtration rate change with sodium-glucose cotransporter-2 inhibitors versus glucagon-like peptide-1 receptor agonists among people with diabetes: A propensity-score matching study. Diabetes, Obesity and Metabolism, 2024; 26(6): 2422-2430.
TREVELLA P, et al. Potential kidney protective effects of glucagon‐like peptide‐1 receptor agonists. Nephrology, 2024; 29: 457-469.
TUTTLE KR, et al. Effects of Once-Weekly Semaglutide on Kidney Disease Outcomes by KDIGO Risk Category in the SUSTAIN 6 Trial. Kidney International Reports, 2024; 9: 2006-2015.
WALGORZATA M e NOWICKI M. The impact of GLP‑1 receptor agonist liraglutide on blood pressure profle, hydration, natriuresis in diabetic patients with severely impaired kidney function. Scientific reports, 2024; 14(1): 5002.
WILLIAMS DM e EVANS M. Semaglutide: Charting New Horizons in GLP-1 Analogue Outcome Studies. Diabetes Therapy, 2020; 11(10): 2221-2235.
ZHAO JZ, et al. Hypoglycemia risk with SGLT2 inhibitors or glucagon-like peptide 1 receptor agonists versus sulfonylureas among medicare insured adults with CKD in the United States. Kidney Medicine, 2022; 4(8): 100510.