Abstract: SA-PO0412
GLP-1 Receptor Agonists (RAs) Use and Kidney and Cardiovascular Outcomes in Adults with CKD and Obesity Without Diabetes: A Retrospective Real-World Study
Session Information
- CKM: Clinical - Epidemiology and Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Ojaimi, Nadim, University of Maryland Medical Center, Baltimore, Maryland, United States
- Cebotaru, Valeriu, University of Maryland Medical Center, Baltimore, Maryland, United States
Background
GLP-1 RAs are increasingly used for obesity management, but outcomes data in adults with CKD and obesity without diabetes remain limited. We evaluated the association between GLP-1 RA use and clinical outcomes in this population using a large real-world electronic health record network.
Methods
We conducted a retrospective cohort study using the TriNetX Research Network, including data from 112 healthcare organizations. Adults aged ≥18 years with CKD and obesity without diabetes were identified. The exposed cohort included patients treated with GLP-1 RAs, including semaglutide, dulaglutide, liraglutide, tirzepatide, lixisenatide, or exenatide. Controls included adults with CKD and overweight/obesity without diabetes who had an outpatient/ambulatory encounter and no GLP-1 RA exposure. Outcomes were assessed from 1 to 1825 days after index. Propensity score matching was performed using demographic characteristics, heart failure, hyperlipidemia, and baseline medication use including ACE inhibitors, angiotensin II receptor blockers, yielding 34,980 patients in each cohort. The primary outcome was a composite renal outcome defined as end-stage renal disease, dialysis, or kidney transplantation. Secondary outcomes included death and heart failure exacerbation. Kaplan-Meier survival analyses were performed.
Results
After propensity score matching, 34,980 patients were included in each cohort. GLP-1 RA use was associated with a lower 5-year risk of the primary renal composite outcome compared with controls: 3.3% vs 6.0%; HR 0.513, 95% CI 0.477–0.551; p<0.001. Renal outcome-free survival was higher among GLP-1 RA users: 93.87% vs 89.83%. Secondary outcomes also favored GLP-1 RA use, including lower mortality: 1.6% vs 5.8%; HR 0.251, 95% CI 0.229–0.276; and lower heart failure exacerbation: 15.5% vs 19.1%; HR 0.744, 95% CI 0.718–0.772; both p<0.001.
Conclusion
These findings suggest potential kidney-protective and cardiorenal benefits of GLP-1 RAs beyond diabetes. Further studies incorporating CKD stage, eGFR, albuminuria, and randomized trials are warranted.
Acknowledgment
Dr Stephen Seliger-Study design.
K-M renal outcomes curve