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Healthcare utilization, mortality, and cardiovascular events following GLP1-RA initiation in chronic kidney disease

Author

Listed:
  • Shuyao Zhang

    (University of Texas Southwestern Medical Center)

  • Fnu Sidra

    (University of Texas Southwestern Medical Center
    The Jones Center for Diabetes & Endocrine Wellness)

  • Carlos A. Alvarez

    (Texas Tech University Health Science Center)

  • Mustafa Kinaan

    (UCF HCA Healthcare GME
    University of Central Florida, College of Medicine)

  • Ildiko Lingvay

    (University of Texas Southwestern Medical Center
    University of Texas Southwestern Medical Center)

  • Ishak A. Mansi

    (University of Central Florida, College of Medicine
    Orlando VA Healthcare System)

Abstract

Treatment with glucagon-like peptide-1 receptor agonists (GLP1-RA) in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) may attenuate kidney disease progression and cardiovascular events but their real-world impact on healthcare utilization and mortality in this population are not well-defined. Here, we emulate a clinical trial that compares outcomes following initiation of GLP1-RA vs Dipeptidyl peptidase-4 inhibitors (DPP4i), as active comparators, in U.S. veterans aged 35 years of older with moderate to advanced CKD during fiscal years 2006 to 2021. Primary outcome was rate of acute healthcare utilization. Secondary outcomes were all-cause mortality and a composite of acute cardiovascular events. After propensity score matching (16,076 pairs) and 2.2 years mean follow-up duration, use of GLP1-RA in patients with moderate to advanced CKD was associated with lower annual rate of acute healthcare utilization and all-cause mortality. There was no significant difference in acute cardiovascular events.

Suggested Citation

  • Shuyao Zhang & Fnu Sidra & Carlos A. Alvarez & Mustafa Kinaan & Ildiko Lingvay & Ishak A. Mansi, 2024. "Healthcare utilization, mortality, and cardiovascular events following GLP1-RA initiation in chronic kidney disease," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-54009-3
    DOI: 10.1038/s41467-024-54009-3
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    References listed on IDEAS

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    1. Hsiu-Lan Li & Pei-Hui Tai & Yi-Ting Hwang & Shih-Wei Lin & Li-Ching Lan, 2022. "Causes of Hospitalization among End-Stage Kidney Disease Cohort before and after Hemodialysis," IJERPH, MDPI, vol. 19(16), pages 1-13, August.
    2. Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, vol. 2(4), pages 358-377, November.
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