TY - JOUR

T1 - Glucagon-like peptide 1 receptor agonist (GLP-1 RA)

T2 - Long-term effect on kidney function in patients with type 2 diabetes

AU - Von Scholten, Bernt Johan

AU - Hansen, Tine Willum

AU - Goetze, Jens Peter

AU - Persson, Frederik

AU - Rossing, Peter

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Aims In a short-term study including 31 patients with type 2 diabetes, glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment was associated with a significant reversible decline in GFR. Twenty-three patients re-initiated GLP-1 RA treatment after the primary study, and the aim was to investigate the long-term effect on kidney function. Methods We included 30 patients in a one-year extension study, all initially treated with liraglutide for seven weeks. During follow-up 23 were treated with liraglutide and seven untreated. Primary outcome was change in GFR (51Cr-EDTA plasma clearance). Results Patients were 61.5 (10.0) years and HbA1c 60.1 (13.8) mmol/mol. Baseline GFR was 100.6 (24.9) mL/min/1.73 m2 and was reduced by 11 (95% CI: 6.6-15.7, p < 0.001) mL/min/1.73 m2, independent of change in 24-h systolic blood pressure (SBP), weight, UAER or HbA1c (p ≥ 0.33). Geometric mean (IQR) of UAER was 25.5 (9.9-50.9) mg/d and was reduced by 27 (95% CI: 5-44; p = 0.020)%, and 24-h SBP was reduced by 8.2 (p = 0.048) mmHg. No changes occurred in untreated patients. Conclusions Long-term treatment with liraglutide was associated with a reduction in measured GFR similar to the effect during short-term treatment, suggesting a metabolic or haemodynamic reversible effect and not structural changes. Moreover, UAER and 24-h SBP were reduced. Trial registration ClinicalTrials.gov identifier: NCT01499108.

AB - Aims In a short-term study including 31 patients with type 2 diabetes, glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment was associated with a significant reversible decline in GFR. Twenty-three patients re-initiated GLP-1 RA treatment after the primary study, and the aim was to investigate the long-term effect on kidney function. Methods We included 30 patients in a one-year extension study, all initially treated with liraglutide for seven weeks. During follow-up 23 were treated with liraglutide and seven untreated. Primary outcome was change in GFR (51Cr-EDTA plasma clearance). Results Patients were 61.5 (10.0) years and HbA1c 60.1 (13.8) mmol/mol. Baseline GFR was 100.6 (24.9) mL/min/1.73 m2 and was reduced by 11 (95% CI: 6.6-15.7, p < 0.001) mL/min/1.73 m2, independent of change in 24-h systolic blood pressure (SBP), weight, UAER or HbA1c (p ≥ 0.33). Geometric mean (IQR) of UAER was 25.5 (9.9-50.9) mg/d and was reduced by 27 (95% CI: 5-44; p = 0.020)%, and 24-h SBP was reduced by 8.2 (p = 0.048) mmHg. No changes occurred in untreated patients. Conclusions Long-term treatment with liraglutide was associated with a reduction in measured GFR similar to the effect during short-term treatment, suggesting a metabolic or haemodynamic reversible effect and not structural changes. Moreover, UAER and 24-h SBP were reduced. Trial registration ClinicalTrials.gov identifier: NCT01499108.

KW - Glomerular filtration rate

KW - GLP-1

KW - Kidney function

KW - Liraglutide

KW - MR-proANP

KW - Urinary albumin excretion rate

UR - http://www.scopus.com/inward/record.url?scp=84930572421&partnerID=8YFLogxK

U2 - 10.1016/j.jdiacomp.2015.04.004

DO - 10.1016/j.jdiacomp.2015.04.004

M3 - Journal article

C2 - 25935863

AN - SCOPUS:84930572421

VL - 29

SP - 670

EP - 674

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

SN - 1056-8727

IS - 5

ER -