GLP-1RA use improves outcomes post partial nephrectomy in T2DM patients with RCC: A TriNetX study

The purpose of this study is to investigate the impact of Glucagon-like peptide-1 receptor agonists (GLP-1RAs) use on 90-day postoperative outcomes and overall survival following partial nephrectomy (PN) for renal cell carcinoma (RCC), where type 2 diabetes mellitus (T2DM) is a common comorbidity.

The TriNetX database was used to retrospectively identify T2DM patients who underwent PN. Patients prescribed GLP-1RAs were identified and matched in a 1:1 ratio with control patients who were not prescribed GLP-1RAs based on baseline characteristics, comorbidities, metformin and insulin prescription, and renal function laboratory values. For 90-day postoperative adverse events, risk difference, risk ratio and odds ratio with 95% confidence intervals were calculated. Kaplan-Meier analysis, log-rank tests and multivariable Cox Proportional Hazards model were performed to measure the effect of GLP-1RAs use on overall survival.

Use of GLP-1RAs was associated with lower odds of acute kidney injury (odds ratio [OR] = 0.712), arrhythmia (OR = 0.725), readmission (OR = 0.8) and ileus (OR = 0.336) compared to the non-GLP-1RAs group (p < 0.05 for each). Kaplan-Meier analysis and log-rank tests demonstrated improved 2-year (p = 0.002) and 3-year (p = 0.001) overall survival among patients prescribed GLP-1RAs compared to those who were not.

Use of GLP-1RAs was associated with reduced incidence of 90-day postoperative complications, such as acute kidney injury, arrhythmia, readmission and ileus, potentially contributing to improved overall survival. These results align with ongoing studies investigating the broader benefits of the use of GLP-1RAs.