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Potential benefits of GLP-1 receptor agonist in dialysis patients with type 2 diabetes: the need for comprehensive pharmacokinetic and hemodialysis analyses

Hsuan-Wen Lai, Jui-Yi Chen, Vin-Cent Wu, Yin-See Chun

Cardiovascular Diabetology, 2025

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Abstract

The 2022 KDIGO guideline for diabetes management in patients with chronic kidney disease (CKD) had endorsed the use of GLP-1 receptor agonists (GLP-1RAs) for patients with CKD and type 2 diabetes who did not achieve optimal glycemic target with maximally tolerated metformin and sodium-glucose co-transporter-2 (SGLT-2) inhibitor. Our study revealed the potential benefits of GLP-1RAs in patients with dialysis-requiring acute kidney disease possibly owing to pleiotropic effects of the medicine. Nonetheless, pharmacokinetics and dialysis dose were omitted in our subgroup analyses. Herein, we would like to raise our concern regarding neglecting these important confounders in our analyses and the impact to the findings of the study.

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