ArticleClinical kidney journal2026
Glucagon-like peptide-1 receptor agonists and cardiovascular outcomes in dialysis patients with type 2 diabetes: a real-world propensity score-matched study.
Article in Clinical kidney journal, 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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7 authors.
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Abstract
Aims: Patients with type 2 diabetes mellitus (T2DM) undergoing dialysis have extremely high cardiovascular and mortality risks, yet evidence for effective therapies is limited. The benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in this population remain unclear. Methods: We conducted a retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network (2013-2022). Among 1688 matched pairs of new GLP-1 RA and dipeptidyl peptidase-4 inhibitor (DPP-4i) users, the primary outcome was major adverse cardiovascular events (MACE), with secondary outcomes of all-cause mortality, heart failure, sepsis, hospitalization, and emergency visits. Results: GLP-1 RA users experienced significantly lower risk of MACE compared with DPP-4i users [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.78-0.99]. GLP-1 RAs were also associated with reduced all-cause mortality (HR 0.84, 95% CI 0.72-0.99), myocardial infarction (HR 0.84, 95% CI 0.70-0.99), heart failure (HR 0.87, 95% CI 0.78-0.98), and sepsis (HR 0.81, 95% CI 0.71-0.92). Healthcare utilization outcomes, such as hospitalization and emergency visits, were also reduced. Findings were consistent across sensitivity and subgroup analyses. Conclusions: In this large real-world dialysis cohort, GLP-1 RAs were associated with improved cardiovascular outcomes, survival, infection risk, and healthcare utilization, supporting their potential role in T2DM patients receiving dialysis.
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