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Updated: Jun 16, 2025

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Benefits of Glucagon-like Peptide-1 Receptor Agonists After Kidney Transplantation

Sukhdeep S Sahi1, Oscar Garcia Valencia1, Jie Na2

  • 1Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|March 7, 2025
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show promise in kidney transplant recipients with type 2 diabetes mellitus, improving survival and kidney function. Further research is recommended to confirm these benefits.

Area of Science:

  • Nephrology
  • Endocrinology
  • Transplantation Immunology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for type 2 diabetes mellitus (T2DM).
  • Their benefits in kidney transplant (KT) recipients, particularly those with T2DM, remain under-investigated.
  • Understanding GLP-1 RA effects in this population is crucial for optimizing post-transplant care.

Purpose of the Study:

  • To evaluate the impact of GLP-1 receptor agonists (GLP-1 RAs) on mortality, kidney outcomes, and metabolic parameters in kidney transplant recipients with type 2 diabetes mellitus.
  • To compare outcomes between KT recipients treated with GLP-1 RAs and a matched reference group not receiving these agents.

Main Methods:

  • Retrospective analysis of KT recipients with T2DM, comparing those treated with GLP-1 RAs (n=77) versus a reference group (n=2094).
  • Utilized analysis of variance, chi-squared tests, and generalized estimating equation models for data analysis.
  • Employed time-dependent Cox regression modeling for GLP-1 RA use and stratified survival analysis by race-ethnicity.

Main Results:

  • GLP-1 RA use was associated with significantly improved survival (P = .049).
  • Treatment led to a decreased urine albumin-to-creatinine ratio (net reduction of 10.62 mg/g per year, P = .003) and slower estimated glomerular filtration rate decline (1.04 vs 1.56 mL/min/1.73 m² per year, P = .04).
  • Lower troponin levels were also observed in the GLP-1 RA group.

Conclusions:

  • GLP-1 receptor agonists (GLP-1 RAs) are associated with reduced mortality and improved kidney function in kidney transplant recipients with type 2 diabetes mellitus.
  • These findings suggest a potential protective role for GLP-1 RAs in this vulnerable patient population.
  • Larger, prospective studies are warranted to definitively establish the risks and benefits of GLP-1 RA therapy in KT recipients.
Keywords:
diabetes mellitusglucagon-like peptide-1 receptor agonistkidney transplantationpost-transplant diabetes mellitus

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