Abstract: TH-OR051
GLP-1 Receptor Agonist Use Associated with Improvement in Hospitalization Rates in Patients with ESKD
Session Information
- Hemodialysis: Novel Interventions
November 06, 2025 | Location: Room 351D, Convention Center
Abstract Time: 05:20 PM - 05:30 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Brunelli, Steven M., DaVita Inc, Denver, Colorado, United States
- Karpinski, Steph, DaVita Inc, Denver, Colorado, United States
- Qazi, Rizwan A., Kidney Specialists of Southern Nevada, Las Vegas, Nevada, United States
- Bjordahl, Terrence S., University of Utah Hospital, Salt Lake City, Utah, United States
- Sibbel, Scott, DaVita Inc, Denver, Colorado, United States
- Weinhandl, Eric D., DaVita Inc, Denver, Colorado, United States
- Tentori, Francesca, DaVita Inc, Denver, Colorado, United States
Background
In a recent clinical trial (FLOW), the GLP-1 agonist Semaglutide reduced the risk of clinically important outcomes and death from cardiovascular causes in patients with type 2 diabetes and chronic kidney disease (CKD) (Perkovic 2024 NEJM). Given the clinical trial benefit in patients with CKD, the clinical question remains whether, and to what degree, these drugs are beneficial to patients with end-stage kidney disease (ESKD). In this analysis, we sought to evaluate the impact of GLP-1 agonist use in incident ESKD patients on hospitalizations.
Methods
Patients included in this analysis were adult ESKD patients who initiated 3x weekly in-center hemodialysis at a kidney care organization between Jan 1, 2018 and Apr 15, 2024. Using internal EHR data, eligible patients who initiated dialysis on a GLP-1a (with an active GLP-1a prescription in the first 30 days after dialysis initiation; n=2,492) were matched 1:1 to those not on a GLP-1a. Matching factors were weight, index date, diabetes, evidence of predialysis nephrology care, and use of diabetes medications during the first 30 days of dialysis. Patients were followed for hospitalizations from index date until end of study (Jul 31, 2024). Incident rate ratios were estimated using a negative binomial distribution with a random intercept to account for the matched nature of the data.
Results
Matched patients filling GLP-1 prescriptions in the first month of dialysis are on average 63 years old, predominately male (57%), White (46%), with a mean BMI of 33. Nearly all patients (98%) have a known diagnosis of diabetes, and a majority have evidence of predialysis nephrology care; very few are dually eligible (<20%). Results indicate that after matching and additional adjustment for residual imbalances in age, race, and dual eligibility, GLP-1s are independently associated with a reduction in hospitalizations [IRR: 0.91 (0.87, 0.96)].
Conclusion
Results indicate that in the context of known diabetic, incident ICHD patients, continued GLP-1 use is independently associated with a 9% reduction in hospitalizations.