Evidence mapPaperPMID 42123715Full record

ArticleInternational journal of molecular sciences2026

Differential Acute Kidney Injury Profiles of GLP-1RAs and SGLT2is: A Network Meta-Analysis.

Chih-Sung Liang, Chih-Wei Hsu, Jiann-Jy Chen, Chao-Ming Hung, Bing-Yan Zeng, Wei-Chieh Yang, Mein-Woei Suen, Hung-Yu Wang, Andre F Carvalho, Brendon Stubbs and 9 more

Abstract readNetwork Meta-Analysis
In one paragraph

Article in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Chih-Sung LiangDepartment of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical University, Taipei 112, Taiwan.
Chih-Wei HsuDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.ORCID 0000-0002-8650-4060
Jiann-Jy ChenProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.
Chao-Ming HungDivision of General Surgery, Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan.
Bing-Yan ZengDepartment of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung 807, Taiwan.
Wei-Chieh YangDepartment of Pediatrics, Ping An Medical Clinic, Tainan 708, Taiwan.ORCID 0000-0002-9880-6955
Mein-Woei SuenDepartment of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.ORCID 0000-0002-3991-0322
Hung-Yu WangKaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 802, Taiwan.
Andre F CarvalhoInnovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia.
Brendon StubbsPsychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London WC2R 2LS, UK.
Yen-Wen ChenProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.
Tien-Yu ChenDepartment of Psychiatry, Tri-Service General Hospital, Taipei 114, Taiwan.ORCID 0000-0001-8462-1311
Wei-Te LeiDivision of Pediatric Allergy, Immunology, and Rheumatology, Department of Pediatrics, Hsinchu Municipal MacKay Children's Hospital, Hsinchu 300, Taiwan.
Shih-Pin HsuSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung 840, Taiwan.
Yow-Ling ShiueInstitute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan.ORCID 0000-0003-0798-5028
Cheng-Ta LiDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan.
Kuan-Pin SuOffice of Research and Development, Asia University, Taichung 413, Taiwan.ORCID 0000-0002-4501-2502
Bing-Syuan ZengDepartment of Internal Medicine, E-Da Cancer Hospital, I-Shou University, No. 21, Yida Rd., Yanchao Dist., Kaohsiung 824, Taiwan.
Ping-Tao TsengProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.ORCID 0000-0001-5761-7800

Funding

National Science and Technology Council 112-2314-B-182-070-MY3
6 · The paper itself

Abstract

Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose co-transporter 2 inhibitors (SGLT2is) have demonstrated protective effects against chronic kidney disease, their impact on acute kidney injury (AKI) remains unclear. AKI and chronic kidney disease share overlapping clinical features but differ in pathogenesis and risk profiles. Previous analyses often grouped diverse agents into single categories, potentially concealing medication-specific renal risks. Given the widespread assumption of renoprotection, particularly among newer agents, there is a need to evaluate the comparative AKI risk of GLP-1RAs and SGLT2is at the individual drug and dose level. We performed a Bayesian network meta-analysis (NMA) following Cochrane-recommended methodology for safety-focused assessments. A systematic literature search across eight databases identified 67 randomized controlled trials (RCTs), including 199,877 participants. Eligible trials reported AKI outcomes or sufficiently explicit acute renal injury-related events associated with GLP-1RA or SGLT2i interventions. The primary outcome was the incidence of AKI; all-cause dropout was analyzed as a general tolerability measure. Odds ratios (ORs) with 95% credible intervals (CrIs) were calculated, and surface under the cumulative ranking curves (SUCRA) were used to estimate relative safety rankings. Only high-dose tirzepatide (10-15 mg/week) was associated with a significantly increased risk of AKI compared to controls (absolute risk difference: 0.28%; number needed to harm: 357). In contrast, lixisenatide, high-dose canagliflozin (300 mg/day), empagliflozin, and dapagliflozin were associated with reduced AKI risk. Risk rankings consistently identified high-dose tirzepatide as the most likely to induce AKI. Subgroup analyses excluding patients with baseline renal impairment yielded consistent results. High-dose tirzepatide may elevate AKI risk despite its metabolic benefits. Clinicians should assess renal vulnerability when prescribing GLP-1RAs or SGLT2is, particularly in patients with preserved kidney function. Further prospective trials are needed to clarify causal mechanisms and inform clinical decision-making.

Indexed as

Acute Kidney InjuryGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 InhibitorsHumansTirzepatideGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 InhibitorsTirzepatideacute kidney injuryadverse effectsGLP-1 receptor agonistnetwork meta-analysisSGLT2 inhibitortirzepatide

Identifiers

PMID42123715
PMCPMC13164542

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.