A comprehensive meta-analysis published in The Lancet Diabetes & Endocrinology highlights the significant kidney and cardiovascular benefits of glucagon-like peptide-1 (GLP-1) receptor agonists for individuals with and without diabetes. This landmark study, the largest of its kind, underscores the potential of these medications to transform care for patients with chronic kidney disease (CKD), cardiovascular disease, obesity, and type 2 diabetes.
Chronic kidney disease affects an estimated 850 million people worldwide—about one in ten individuals. It is the tenth leading cause of death globally and is projected to become the fifth leading cause by 2050. CKD frequently leads to kidney failure requiring dialysis or transplantation and is closely linked to premature death, often from heart disease.
Originally developed for diabetes management, GLP-1 receptor agonists mimic the hormone glucagon-like peptide-1, stimulating insulin production and lowering blood sugar levels. More recently, they have been recognised as effective treatments for obesity, slowing digestion, increasing satiety, and reducing hunger. However, their role in managing CKD has remained unclear until now.
Researchers analysed 11 large-scale clinical trials involving 85,373 participants, including 67,769 individuals with type 2 diabetes and 17,604 with obesity or cardiovascular disease but no diabetes. Seven GLP-1 receptor agonists, including semaglutide (Ozempic/Wegovy), dulaglutide (Trulicity), and liraglutide (Victoza), were assessed.
As per the analysis, GLP-1 receptor agonists reduced the risk of kidney failure by 16%, worsening kidney function by 22% and the combined risk of kidney failure, worsening kidney function, and death from kidney disease by 19%.
These medications also reduced the risk of cardiovascular death, non-fatal heart attacks, and non-fatal strokes by 14% and the risk of death from any cause by 13%.
The study authors emphasise the groundbreaking nature of the findings. This is the first study to show a clear benefit of GLP-1 receptor agonists on kidney failure or end-stage kidney disease, suggesting they have a key role in kidney- and heart-protective treatment for patients with common conditions like type 2 diabetes, obesity, cardiovascular disease, or CKD.
This research shows that GLP-1 receptor agonists could play a pivotal role in addressing the global burden of non-communicable diseases. This study will significantly influence clinical guidelines for managing CKD and cardiovascular disease in patients with or without diabetes.
These findings highlight the urgent need to integrate GLP-1 receptor agonists into routine clinical practice, ensuring access for those who could benefit. More work is needed to translate these results into practice and expand access to GLP-1 receptor agonists for patients worldwide.
Source: George Institute for Global Health
Image Credit: iStock
References:
Badve SV et al. (2024) Effects of GLP-1 receptor agonists on kidney and cardiovascular disease outcomes: a meta-analysis of randomised controlled trials. The Lancet Diabetes & Endocrinology.
