Abstract: SA-PO0528
Association of GLP-1 Receptor Agonist with Risk of Frailty-Related Outcomes in CKD
Session Information
- CKD: Clinical - Therapies, CKM Health, Special Populations, and More
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Wang, Jiayan, University Hospitals Health System, Cleveland, Ohio, United States
- Negrea, Lavinia Aura, University Hospitals Health System, Cleveland, Ohio, United States
- Rajagopalan, Sanjay, University Hospitals Health System, Cleveland, Ohio, United States
- Dobre, Mirela A., University Hospitals Health System, Cleveland, Ohio, United States
Background
Frailty is common in chronic kidney disease (CKD) and is associated with falls, fractures, disability, hospitalization, and mortality. Although GLP-1 receptor agonists (GLP-1RA) improve cardiometabolic risk, their effects on frailty-related outcomes in CKD remain uncertain due to concerns regarding weight loss and sarcopenia. We evaluated the association of GLP-1RA use versus SGLT2 inhibitor (SGLT2i) use with the risk of frailty-related clinical events in adults with CKD.
Methods
In a population-based study, using the TriNetX network of 111 US health care organizations (May 2026), we identified patients aged≥18 years, with CKD stages 3-5 treated with either GLP-1RAs without SGLT2i or SGLT2i without GLP-1RAs. Propensity score matching was performed for demographics, comorbidities, and medications associated with frailty risk. Outcomes included age-related physical debility, sarcopenia, recurrent falls, weakness, abnormal gait and mobility and fragility fractures at one year from the index event (GLP1-RA/SGLT2i prescription). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards regression models. Patients receiving dialysis or kidney transplantation were excluded. Patients were censored at the time of death or lost to follow-up.
Results
After propensity matching, 78,684 patients were included in each group. Compared to SGLT2i users, GLP-1RA users had lower risk of age-related physical debility (HR 0.62 95% CI 0.54-0.71), weakness (HR 0.94, 95% CI 0.91-0.98), femur fracture (HR 0.73, 95% 0.65-0.82), spine fracture (HR 0.81 95% 0.75-0.88); and a higher risk of abnormal gait and mobility (HR 1.09, 95% 1.04-1.13). There was no significant difference between the two groups in terms of sarcopenia (HR 0.84 95% CI 0.57-1.24), recurrent falls (HR 0.97, 95% CI 0.93-1.01), and shoulder/arm fracture (HR 0.96, 95% 0.88-1.05).
Conclusion
In adults with CKD, GLP-1RA use was associated with lower risks of several frailty- and fracture-related outcomes compared with SGLT2i use, without increased risk of sarcopenia or recurrent falls. Further studies are needed to clarify the effects of GLP-1RAs on physical function and mobility in CKD.