{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:32Z","timestamp":1787017952786,"version":"build-2736575974"},"reference-count":24,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiorenal Med"],"abstract":"<jats:p>Introduction: The effects of glucagon-like peptide 1 receptor agonists (GLP-1 RA) in patients with diabetes and established chronic kidney disease (CKD) remain unclear. Methods: We systematically searched PubMed, Embase, and Cochrane Library from inception to May 2024 for randomized controlled trials (RCTs) and respective post hoc studies comparing GLP-1 RAs versus placebo in patients with type 2 diabetes mellitus (T2DM) and established CKD (as per study definition or otherwise defined as having an estimated glomerular filtration rate less than 60 mL\/min\/1.73 m2 and\/or urine albumin-to-creatinine ratio more than 30 mg\/g). We applied a random-effects model to pool risk ratios (RRs), hazard ratios (HRs), and 95% confidence intervals (CIs). Results: We included 10 RCTs and post hoc analyses comprising 18,042 patients, of whom 9,164 (50.8%) were treated with GLP-1 RAs. There were significantly lower rates of major adverse kidney events (RR 0.82; 95% CI: 0.74\u20130.90; p &lt; 0.001; high certainty) and a slightly lower incidence of all-cause mortality (HR 0.84; 95% CI: 0.71\u20131.00; p = 0.046; moderate certainty) with the use of GLP-1 RAs relative to placebo. This kidney protection remained consistent in patients with stage 3b CKD (RR 0.78; 95% CI: 0.65\u20130.94; p = 0.009; high certainty). No significant differences were observed in major adverse cardiovascular events (HR 0.89; 95% CI: 0.78\u20131.02; p = 0.090; low certainty) or cardiovascular mortality (HR 0.80; 95% CI: 0.60\u20131.09; p = 0.155; very low certainty), possibly due to a lack of statistical power. Conclusion: GLP-1 RAs were tied to a lower incidence of all-cause mortality and major adverse kidney events in patients with T2DM and established CKD.<\/jats:p>","DOI":"10.1159\/000543149","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T12:00:52Z","timestamp":1735819252000},"page":"98-107","source":"Crossref","is-referenced-by-count":17,"title":["Cardiovascular and Kidney Outcomes of Glucagon-Like Peptide 1 Receptor Agonist Therapy in Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Meta-Analysis"],"prefix":"10.1159","volume":"15","author":[{"given":"Nicole","family":"Felix","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus 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Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Tramujas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Moura-Neto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8500-0218","authenticated-orcid":false,"given":"Maria Gabriela","family":"Guimar\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.010"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10924"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001209"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0027"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32261-X"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31149-3"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v4.i5.190"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1603827"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01584-3"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2737"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/diseases12010014"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15417"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509225"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1612917"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901118"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607141"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.123"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30249-9"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00203-5"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2023.100502"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55060233"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307563"}],"container-title":["Cardiorenal 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