OBJECTIVE: Benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in kidney transplant (KT) recipients have not been adequately studied. METHODS: We retrospectively examined the effects of GLP-1 RA on mortality, kidney outcomes and metabolic parameters in KT recipients with type 2 diabetes mellitus (T2DM) treated versus not treated with GLP-1 RA. A reference group of KT recipients not treated with GLP-1 RA was used for comparison. Data were analyzed using analysis of variance, χ2 tests, and generalized estimating equation models. GLP-1 RA was used as a time-dependent model in Cox regression modeling. For survival analysis, the final model fitting was stratified by race-ethnicity. RESULTS: Seventy-seven KT recipients with T2DM were treated with GLP-1 RA for at least 12 months. Reference group included 2094 patients not on GLP-1 RA. The mean (SD) age at transplant was 57.9 (9.5) and 60.8 (9.5) years for the treatment and reference groups, respectively. Median follow-up time from the index date for mortality was 1.5 (IQR 0.99, 2.4) in the treatment and 5.8 (IQR 3.4, 9.1) years in the reference group. GLP-1 RA use was associated with improved survival (P = .049), decreased urine albumin to creatinine ratio (net reduction of 10.62 mg/g per year, P = .003), slower estimated glomerular filtration rate decline (1.04 vs 1.56 mL/min/1.73 m2 per year, P = .04), and lower troponin levels. CONCLUSIONS: GLP-1 RA in KT recipients with T2DM was associated with reduced mortality, and improved kidney function compared to the reference group. Larger, prospective studies are needed to fully evaluate the risks and benefits of GLP-1 RA therapy in KT recipients.

Department of Cardiovascular Surgery Research Mayo Clinic Rochester Minnesota

Department of Health Sciences Research Division of Biomedical Statistics and Informatics Mayo Clinic Rochester Minnesota

Department of Internal Medicine Division of Nephrology and Transplant Mayo Clinic Phoenix Arizona

Department of Medicine Division of Endocrinology Diabetes Metabolism and Nutrition Mayo Clinic Rochester Minnesota

Department of Medicine Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota

Department of Medicine Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota; Department of Urology University Hospital Hradec Kralove Czechia; Charles University Faculty of Medicine in Hradec Kralove Czechia

Department of Medicine Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota; Von Liebig Transplant Center Mayo Clinic Rochester Minnesota

Department of Nephrology and Hypertension Research Mayo Clinic Rochester Minnesota

Department of Pharmacy Mayo Clinic Rochester Minnesota

Department of Surgery and Immunology Mayo Clinic Rochester Minnesota

Department of Surgery and Immunology Mayo Clinic Rochester Minnesota; Von Liebig Transplant Center Mayo Clinic Rochester Minnesota

Department of Transplant Mayo Clinic Jacksonville Florida

Von Liebig Transplant Center Mayo Clinic Rochester Minnesota; Department of Medicine Division of Endocrinology Diabetes Metabolism and Nutrition Mayo Clinic Rochester Minnesota

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