Weight-loss drugs can reduce the risk of worsening kidney function, kidney failure and dying from kidney disease by a fifth, according to a study.
Glucagon-like peptide-1 (GLP-1) receptor agonists are a family of medications that help people shed pounds, manage blood sugar in patients with type 2 diabetes, and prevent heart attacks and strokes in people with heart disease.
But while the drugs’ benefits for treating obesity, type 2 diabetes and cardiovascular disease are well known, their potential impact on kidney health has been less certain.
Now the largest and most comprehensive analysis of GLP-1 receptor agonists on kidney outcomes suggests they may have significant benefits. The findings were published in the Lancet Diabetes & Endocrinology journal.
Researchers conducted a meta-analysis of 11 large-scale clinical trials of weight-loss drugs involving more than 85,000 people. The group included people with type 2 diabetes, and people with cardiovascular disease who were overweight or obese but did not have type 2 diabetes.
Seven different GLP-1 receptor agonists were investigated in the trials, including semaglutide, also known as Ozempic or Wegovy, dulaglutide and liraglutide.
Compared with placebo, GLP-1 receptor agonists reduced the risk of kidney failure by 16% and the worsening of kidney function by 22%, researchers said. The combined reduction in the risk of kidney failure, worsening kidney function and death from kidney disease was 19%.
The analysis also confirmed previous findings that weight loss drugs protect cardiovascular healthwith a 14% reduction in the risk of cardiovascular death, non-fatal heart attack and non-fatal stroke, compared to placebo. Death from any cause was 13% lower among patients treated with GLP-1 receptor agonists.
Lead author Prof Sunil Badve, Professorial Fellow at the George Institute for Global Health and UNSW Sydney, said the study expanded current knowledge about the potential benefits of the drugs.
“This is the first study to show a clear benefit of GLP-1 receptor agonists on renal failure or end-stage renal disease, suggesting that they play a key role in renal protective and cardioprotective treatment for patients with common medical conditions such as type 2 diabetes, obesity or obesity with cardiovascular disease, or CKD [chronic kidney disease],” he said.
“These results are particularly important for patients with chronic kidney disease. It is a progressive condition that eventually leads to kidney failure requiring dialysis or a kidney transplant and is associated with premature death, mostly from heart disease. This has a significant impact on patients’ quality of life and incurs significant healthcare costs.”
CKD is estimated to affect one in 10 people worldwide, equivalent to approximately 850 million people. It is the 10th leading cause of death and is expected to become the fifth most common cause of death by 2050.
Prof Vlado Perkovic, Professorial Fellow at the George Institute, Provost at UNSW Sydney and senior author of the study, said: “This research shows that GLP-1 receptor agonists can play an important role in addressing the global burden of non-communicable diseases.
“Our study will have a major impact on clinical guidelines for the management of chronic kidney disease and cardiovascular disease in people with and without diabetes.
“More work is now needed to implement the results of this study into clinical practice and improve access to GLP-1 receptor agonists for people who would benefit from them.”
