Glucagon-like peptide-1 receptor agonists in diabetic kidney disease: A review of their kidney and heart protection.
Publication Title
Am J Prev Cardiol
Document Type
Article
Publication Date
6-1-2023
Keywords
washington; spokane; pmrc; Cardiovascular disease; Chronic kidney disease; Diabetic kidney disease; GLP1-RA; Type 2 diabetes
Abstract
IMPORTANCE: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality for patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). However, testing for albuminuria among patients with T2D is substantially underutilized in clinical practice; many patients with CKD go unrecognized. For patients with T2D at high cardiovascular risk, or with established CVD, the glucagon-like peptide-1 receptor agonists (GLP1-RA) have been shown to reduce ASCVD in cardiovascular outcome trials, while potential kidney outcomes are being explored.
OBSERVATIONS: A recent meta-analysis found that GLP1-RA reduced 3-point major adverse cardiovascular events by 14% [HR, 0.86 (95% CI, 0.80-0.93)] in patients with T2D. The benefits of GLP1-RA to reduce ASCVD were at least as large among people with estimated glomerular filtration rate (eGFR)/min/1.73 m
CONCLUSIONS AND RELEVANCE: Despite their well-described ASCVD benefits and potential kidney protective mechanisms, GLP1-RA remain underutilized in clinical practice. This highlights the need for cardiovascular clinicians to influence and implement use of GLP1-RA in appropriate patients, including those with T2D and CKD at higher risk for ASCVD.
Area of Special Interest
Kidney & Diabetes
Area of Special Interest
Cardiovascular (Heart)
Specialty/Research Institute
Endocrinology
Specialty/Research Institute
Nephrology
Specialty/Research Institute
Cardiology
DOI
10.1016/j.ajpc.2023.100502
