GLP-1RAs Use and Postoperative Outcomes in T2DM Patients Undergoing Radical Nephrectomy

To determine the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and postoperative outcomes, including 90-day complications and overall survival, in patients with type 2 diabetes mellitus (T2DM) undergoing radical nephrectomy (RN) for renal cell carcinoma (RCC).

This retrospective study was conducted using the TriNetX database. The cohort of T2DM patients who underwent RN and were prescribed GLP-1RAs was identified and matched 1:1 with non-GLP-1RA controls based on demographics, comorbidities, metformin and insulin prescription, and renal function laboratory values. Risk difference, risk ratio, and odds ratio with 95% confidence intervals were measured for 90-day postoperative complications. Kaplan-Meier analysis, log-rank tests, and multivariable Cox proportional hazards models evaluated the association of GLP-1RA use with overall survival.

GLP-1RAs use was associated with decreased odds of arrhythmia (odds ratio [OR] = 0.766) and ileus (OR = 0.405) compared to the non-GLP-1RAs group (P < .05 for each). No significant association was observed between GLP-1RAs use and odds of acute kidney injury (P > .05). Kaplan-Meier analysis and log-rank tests showed improved 2-year and 3-year overall survival among patients prescribed GLP-1RAs compared to those who were not (P < .001 for each).

Our study parallels ongoing studies examining the broader benefits of GLP-1RA use, demonstrating a decreased incidence of 90-day postoperative ileus and arrhythmia, as well as improved overall survival. Prospective studies are warranted to validate these findings.