Association of GLP-1 Receptor Agonist Use with Kidney and Cardiovascular Outcomes in Stable Kidney Transplant Recipients

Abstract

Recent surges in the use of glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown promise in reducing cardiovascular events and improving kidney function in patients with type 2 diabetes. Due to these hopeful improvements, kidney transplant recipients (KTRs) have started using GLP-1RA. However, their effects in KTRs remain largely unstudied in clinical studies. This thesis uses a large-scale Electronic Health Record (EHR) database to perform a retrospective cohort analysis to study the association between GLP-1RA use and kidney and cardiovascular outcomes amongst stable KTRs. Primary outcomes include all-cause mortality, major adverse kidney events (MAKE), and major adverse cardiac events (MACE). Among stable KTRs, GLP-1RA users show reduced risk for all-cause mortality (adjusted hazard ratio [aHR]: 0.45; 95% confidence interval [CI]: 0.32-0.62) and MAKE (aHR: 0.69; 95% CI: 0.58-0.81), but no significant difference for MACE (aHR: 0.84; 95% CI: 0.67-1.05). In addition, users show increased risk for irritable bowel syndrome (IBS) (aHR: 2.11; 95% CI: 1.07-4.15) and urinary tract infection (UTI) (aHR: 1.53; 95% CI: 1.27-1.85). These results indicate the potential of GLP-1RA to reduce mortality and adverse kidney outcomes and increase IBS and UTI in KTRs.