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Use of glucagon-like peptide type 1 receptor agonists in kidney transplant recipients

Luis Alberto Vigara1, Florentino Villanego2, Cristhian Orellana2

  • 1Department of Nephrology, Puerta del Mar University Hospital, Cádiz, Spain; Department of Nephrology, Jerez de la Frontera University Hospital, Cádiz, Spain.

Nefrologia
|December 7, 2024
PubMed
Abstract

Insights

Glucagon-like peptide 1 receptor agonists (GLP1-RA) show promise in managing diabetes mellitus (DM) in kidney transplant (KT) recipients. This study found GLP1-RA safe and effective, improving proteinuria, weight, glycemic control, and cardiovascular risk factors without impacting graft survival.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus (DM) in kidney transplant (KT) recipients is linked to increased mortality and reduced graft survival.
  • Glucagon-like peptide 1 receptor agonists (GLP1-RA) offer cardiovascular and renal benefits in the general population, but evidence in KT recipients is limited.

Purpose of the Study:

  • To evaluate the efficacy and safety of GLP1-RA in KT recipients with DM.

Main Methods:

  • A multicenter retrospective cohort study included 96 KT patients with DM treated with GLP1-RA between 2016 and 2022.
  • Data collected included eGFR, proteinuria, weight, glycemic control, blood pressure, lipid profile, and tacrolimus levels.
  • Outcomes assessed were changes in these parameters, acute rejection (AR), and de novo donor-specific antibodies (dnDSA).

Main Results:

  • GLP1-RA treatment led to significant reductions in proteinuria, weight, HbA1c, systolic blood pressure, total cholesterol, and LDL cholesterol at 6 and 12 months.
  • Estimated glomerular filtration rate (eGFR) remained stable, and tacrolimus levels were unchanged.
  • No episodes of AR or dnDSA were observed during the follow-up period.

Conclusions:

  • GLP1-RA represent a safe and effective therapeutic option for managing DM in kidney transplant recipients.
  • The findings support the use of GLP1-RA to improve metabolic and cardiovascular profiles in this patient population without compromising graft integrity.
Keywords:
Agonistas del receptor del péptido 1 similar al glucagónCardiovascular risk factorsDiabetes mellitusGlucagon-like peptide-1 receptor agonistsImmunosuppressionInmunosupresiónKidney transplantationObesidadObesityRiesgo cardiovascularTrasplante renal

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