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Kidney Week

Abstract: PO1023

Impacts of Glucagon-Like Peptide 1 Analogues and Sodium Glucose Cotransporter 2 Inhibitor on Type 2 Diabetes Patients with Renal Impairment

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Author

  • Hiramatsu, Takeyuki, Konan Kosei Hospital, Konan, Aichi, Japan
Background

Diabetes mellitus (DM) is a progressive multifactorial disease associated with cardiovascular complications. To prevent the progression of cardiovascular complications in DM patients, we examined impact on cardiac function between glucagon like peptide-1(GLP-1) analogue and sodium-glucose cotransporter-2 (SGLT-2) inhibitors to treat type 2 diabetes patients with renal impairment.

Methods

A total of 156 type 2 DM patients with renal impairment were recruited for this study. All patients were divided into two groups according to the anti-diabetic agents at baseline : Group G; 0.9mg/day liraglutide, n=72, Group S; n=84; 5mg/day dapagliflozin , n=52, empagliflozin n=32. Blood glucose levels, glycosylated hemoglobin (HbA1c), serum creatinine, and albuminuria were obtained 12 months before and every 3 months for 36 months. Echocardiography, cardio-ankle vascular index(CAVI) were obtained every 12 months for 36 months.

Results

HbA1c and systolic blood pressure were significantly decreased after ADAs. The eGFRs were gradually decreased in both groups. Albuminuria was decreased significantly after initiation of ADAs. Left ventricular mass index (LVMI) and left atrial volume index (LAVi) were significantly decreased in both groups. Cardiac systolic function indicated by ejection fraction and diastolic function indicated by E/e’or left atrial dimension were remained or improved only in group G. Moreover, arterial stiffness indicated by cardio-ankle vascular index (CAVI) was improved in group G (Table1).

Conclusion

These findings suggest that liraglutide and SGLT-2 inhibitor for type 2 DM patients with renal impairment have similar effects on renal function including eGFR and albuminuria and left ventricular and atrial volume. However, liraglutide could provide more benefit for arterial stiffness than SGLT-2 inhibitors.

Table 1 : Clinical Data
  at baselineafter 12 monthsafter 24 monthsafter 36 months
LVMI(g/m2)Group G135.8 ± 45.8110.2 ± 30.3*114.5 ± 41.5*107.2 ± 38.2*
Group S130.0 ± 43.9113.2 ± 36.5*106.4 ± 34.2*115.9 ± 29.5*
LAVI(mL/m2)Group G25.6 ± 6.722.3 ± 5.2*21.4 ± 5.7*20.8 ± 5.8*
Group S24.0 ± 3.521.8 ± 3.8*21.7 ± 3.5*22.7 ± 4.3**
E/eGroup G12.9 ± 3.010.4 ± 2.5*9.4 ± 2.4*9.8 ± 3.1*
Group S12.4 ± 3.310.6 ± 3.9*12.5 ± 3.712.9 ± 3.9
CAVIGroup G10.2 ± 1.79.9 ± 1.39.9 ± 1.19.9 ± 1.2
Group S10.3 ± 2.010.5 ± 1.910.6 ± 1.7*†10.6 ± 1.7*†

* : p<0.01, ** : p<0.05 vs at baseline, † : p<0.05 vs Group G