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Sepsis and Infectious Outcomes for GLP-r Agonists in CKD plus Type 2 Diabetes
Yu-Yang Tseng1, Hsien-Yi Wang2,3, Jui-Yi Chen2,4
1Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1RA) show reduced sepsis risk in chronic kidney disease (CKD) patients. GLP-1RA therapy also lowered mortality and infection rates compared to dipeptidyl peptidase-4 inhibitors.
Area of Science:
- Nephrology
- Endocrinology
- Infectious Diseases
Background:
- Chronic kidney disease (CKD) elevates sepsis risk and worsens outcomes.
- Glucagon-like peptide-1 receptor agonists (GLP-1RA) may protect against sepsis in diabetes, but their role in CKD is unknown.
Purpose of the Study:
- To assess the association between GLP-1RA therapy and infectious outcomes in patients with CKD.
Main Methods:
- Retrospective cohort study using the TriNetX database.
- Adults with CKD and type 2 diabetes mellitus initiating GLP-1RAs or dipeptidyl peptidase-4 inhibitors (DPP-4i) were analyzed.
- Propensity score matching was used to compare outcomes.
Main Results:
- GLP-1RA use was linked to a significantly lower risk of sepsis (HR=0.72) versus DPP-4i.
- Reduced risks were observed for all-cause mortality, pneumonia, urinary tract infection, and COVID-19 with GLP-1RA.
- The risk of septic shock was numerically lower but not statistically significant.
Conclusions:
- GLP-1RA therapy is associated with decreased risks of sepsis, mortality, and infections in CKD patients with type 2 diabetes mellitus.
- No significant difference in septic shock risk was found between GLP-1RA and DPP-4i groups.
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