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Effect of glucagon-like peptide-1 receptor agonists on renal function: A meta-analysis of randomized controlled

Mario Simental-Mendía1, Enrique Linden-Torres2, Adriana Sánchez-García3

  • 1Department of Orthopedics and Traumatology, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico.

British Journal of Clinical Pharmacology
|March 12, 2022
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce urinary albumin excretion and albumin-to-creatinine ratio. However, GLP-1 RAs do not significantly alter serum creatinine or glomerular filtration rate in patients.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for managing type 2 diabetes and obesity.
  • Emerging evidence suggests potential renal benefits of GLP-1 RAs, necessitating a comprehensive analysis.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the effects of GLP-1 RAs on key renal function parameters.
  • To synthesize data from randomized controlled trials (RCTs) to determine the impact on serum creatinine, glomerular filtration rate (GFR), and urinary albumin excretion.

Main Methods:

  • Systematic literature search across major databases (PubMed-MEDLINE, Scopus, Web of Science, ClinicalTrials.gov, Google Scholar).
  • Meta-analysis using a random-effects model, incorporating sensitivity analyses.
  • Inclusion of data from 18 RCTs involving 12,192 participants.

Main Results:

  • GLP-1 RA treatment demonstrated no significant impact on serum creatinine levels (WMD: 0.00 mg/mL) or GFR (WMD: 1.01 mL/min/1.73 m²).
  • A significant reduction was observed in urinary albumin excretion (WMD: -18.01 mg/day) and albumin-to-creatinine ratio (WMD: -6.74 mg/g).

Conclusions:

  • GLP-1 RA therapy effectively reduces markers of kidney damage, specifically albuminuria.
  • These findings indicate a renoprotective effect of GLP-1 RAs, independent of changes in overall renal filtration or serum creatinine.
Keywords:
albumin excretionalbumin-to-creatinine ratiocreatinineglomerular filtrationglucagon-like peptide-1 receptor agonists

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