Impact of GLP-1 receptor agonist-based therapies on cardiovascular and renal outcomes in diabetic and non-diabetic patients with CKD

Article Article scientifique Revue de la littérature Impact of GLP-1 receptor agonist-based therapies on cardiovascular and renal outcomes in diabetic and non-diabetic patients with CKD eng 2025-07-02 author Siniukovich Aliona Faculty of Medicine, University of Geneva, Geneva, Switzerland. 928507 Structure enseignement (ENSI) author Travlos Christoforos K Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Division of Clinical and Translational Research, Department of Medicine, McGill University, Montreal, QC, Canada. author Freedman Sarah Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada. author Mavrakanas Thomas A Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Division of Clinical and Translational Research, Department of Medicine, McGill University, Montreal, QC, Canada.,Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada. author Gariani Karim Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Department of Medical Specialties, Geneva University Hospitals, Geneva, 1205, Switzerland. karim.gariani@hcuge.ch.,Faculty Diabetes Center, University of Geneva Medical Center, University of Geneva, Geneva, Switzerland. karim.gariani@hcuge.ch. 542849 Département de médecine (DEMED) 247 10.1186/s13098-025-01831-4 40605083 1758-5996 PMC12220177 https://link.springer.com/article/10.1186/s13098-025-01831-4 Background: The effect of glucagon-like peptide-1 (GLP-1) receptor agonists-based therapies on cardiovascular and renal outcomes has not been systematically reviewed across baseline kidney function groups. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) with GLP-1 Receptor Agonists (RAs) in patients with and without chronic kidney disease (CKD). Methods: We performed a PubMed/Medline search of randomized, placebo-controlled, event-driven outcome trials of GLP-1 RAs versus placebo in patients with and without diabetes from inception to January 2025. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2. The primary outcome was major adverse cardiovascular events (MACE). Secondary outcomes included hospitalization for heart failure, CKD progression, cardiovascular and all-cause mortality. The relative risk (RR) was estimated using a random-effects model. Results: Nine RCTs were included with a total of 75,088 patients, including 17,568 with eGFR < 60 ml/min/1.73m2. Use of an GLP-1 RA in patients with CKD was associated with a lower incidence of MACE (RR 0.84; 95% CI 0.74-0.95; P 0.006) and of CKD progression (RR 0.85, 95% CI 0.77-0.94; P 0.002), compared with placebo. There was no differential treatment effect of GLP-1 RA on these endpoints by CKD status at baseline. Conclusions: GLP-1 RAs offer substantial cardiovascular and renal protection in patients with CKD. These findings support their use in CKD patients and confirms that these therapies may be continued as kidney function declines. Dewey 616 Swiss National Science Foundation Leveraging next generation 7 Tesla MRI to enhance diagnosis and therapeutic monitoring of diabetic polyneuropathy 10005333 CH 56 Département de médecine 221 false 1263 MASLD/MASH et résistance à l'insuline 997 Diabetology & metabolic syndrome 17 1 760e2ab0-686e-4b55-a227-fa3bd626a358 Article (Published version) Public Article_scientifique_from_crossref.pdf 1853880 application/pdf CC BY-NC-ND-4.0 697acf296284e96208f6d8b98b95524a4d86adc2cd25b8cbfe1fae5e7532faa4 64776acd-74b2-4d17-9d85-2ead536ab081 Supplemental data Public 13098_2025_1831_MOESM1_ESM.docx 775645 application/vnd.openxmlformats-officedocument.wordprocessingml.document ec0f981ee9124b54f701bd6c17fbf467a2e4ad0544ffecabcf311903fd23c046 openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Impact of GLP-1 receptor agonist-based therapies on cardiovascular and renal outcomes in diabetic and non-diabetic patients with CKD	Diabetology & metabolic syndrome			2025	19	84

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