Glucagon-like peptide 1 receptor agonist (GLP-1 RA): long-term effect on kidney function in patients with type 2 diabetes.

Abstract

AIMS:

In a short-term study including 31 patients with type 2 diabetes, glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment was associated with a significant reversible decline in GFR. Twenty-three patients re-initiated GLP-1 RA treatment after the primary study, and the aim was to investigate the long-term effect on kidney function.

METHODS:

We included 30 patients in a one-year extension study, all initially treated with liraglutide for seven weeks. During follow-up 23 were treated with liraglutide and seven untreated. Primary outcome was change in GFR ((51)Cr-EDTA plasma clearance).

RESULTS:

Patients were 61.5 (10.0) years and HbA(1c) 60.1 (13.8) mmol/mol. Baseline GFR was 100.6 (24.9) mL/min/1.73 m(2) and was reduced by 11 (95% CI: 6.6-15.7, p < 0.001) mL/min/1.73 m(2), independent of change in 24-h systolic blood pressure (SBP), weight, UAER or HbA(1c) (p≥0.33). Geometric mean (IQR) of UAER was 25.5 (9.9-50.9) mg/d and was reduced by 27 (95% CI: 5-44; p = 0.020)%, and 24-h SBP was reduced by 8.2 (p = 0.048) mmHg. No changes occurred in untreated patients.

CONCLUSIONS:

Long-term treatment with liraglutide was associated with a reduction in measured GFR similar to the effect during short-term treatment, suggesting a metabolic or haemodynamic reversible effect and not structural changes. Moreover, UAER and 24-h SBP were reduced.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT01499108.

• Authors: Bernt Johan von Scholten, Tine Willum Hansen, Jens Peter Goetze, Frederik Persson, Peter Rossing
• Journal: Journal of diabetes and its complications (J Diabetes Complications) Vol. 29 Issue 5 Pg. 670-4 (Jul 2015) ISSN: 1873-460X [Electronic] United States
• PMID: 25935863 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• GLP1R protein, human
• Glucagon-Like Peptide-1 Receptor
• Glycated Hemoglobin A
• Hypoglycemic Agents
• hemoglobin A1c protein, human
• Liraglutide

Topics

• Aged
• Albuminuria (etiology)
• Diabetes Mellitus, Type 2 (complications, drug therapy, metabolism, physiopathology)
• Diabetic Nephropathies (physiopathology, prevention & control)
• Female
• Follow-Up Studies
• Glomerular Filtration Rate (drug effects)
• Glucagon-Like Peptide-1 Receptor (agonists, metabolism)
• Glycated Hemoglobin (analysis)
• Humans
• Hyperglycemia (prevention & control)
• Hypoglycemic Agents (therapeutic use)
• Kidney (drug effects, physiopathology)
• Liraglutide (therapeutic use)
• Male
• Middle Aged
• Renal Insufficiency (physiopathology, prevention & control)