{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:48:59Z","timestamp":1790801339293,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","funder":[{"DOI":"10.13039\/100006512","name":"School of Medicine, Duke University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006512","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Glucagon-like peptide-1 receptor agonists are increasingly used in patients with kidney failure despite trial exclusion.<\/jats:p>\n <\/jats:list-item>\n \n Initiation was associated with a 13% lower risk of cardiovascular events and 17% lower mortality versus dipeptidyl peptidase-4 inhibitors.<\/jats:p>\n <\/jats:list-item>\n \n Initiation was associated with a 10% lower risk of heart failure hospitalization versus dipeptidyl peptidase-4 inhibitors.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Few therapies improve cardiovascular outcomes for people with kidney failure. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduce cardiovascular risk in patients with non\u2013dialysis-dependent CKD, but the cardiovascular benefits in patients with kidney failure remain uncertain. The objective of this study was to compare cardiovascular outcomes among patients with kidney failure and type 2 diabetes newly initiated on GLP-1 RA versus other antiglycemic agents.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We analyzed electronic health records, Medicare claims, and Part D data from the United States Renal Data System (2011\u20132021) to identify new users of GLP-1 RA (\n n<\/jats:italic>\n =3629), dipeptidyl peptidase-4 inhibitors (DPP4i;\n n<\/jats:italic>\n =21,369), and sulfonylureas (\n n<\/jats:italic>\n =32,296) among patients with type 2 diabetes receiving maintenance dialysis. For the primary analysis, we performed 1:1 propensity score matching of GLP-1 RA to DPP4i initiators using 61 covariates. A prespecified secondary analysis compared propensity score\u2013matched initiators of GLP-1 RA and sulfonylureas. The primary outcome was a modified major adverse cardiovascular event (MACE) composite of myocardial infarction, stroke, or all-cause mortality. Secondary outcomes included the individual components of the primary outcome and hospitalizations for heart failure. Cause-specific Cox models were used to estimate hazard ratios (HRs).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 3284 matched pairs of GLP-1 RA and DPP4i initiators, GLP-1 RA use was associated with lower risks of MACE (HR, 0.87; 95% confidence interval [CI], 0.78 to 0.97), all-cause mortality (HR, 0.83; 95% CI, 0.74 to 0.94), and heart failure hospitalization (HR, 0.90; 95% CI, 0.83 to 0.99) over up to 2 years of follow-up. Among 2792 matched pairs, GLP-1 RA and sulfonylurea initiators, GLP-1 RA was associated with lower risks of MACE (HR, 0.83; 95% CI, 0.74 to 0.93) and all-cause mortality (HR, 0.80; 95% CI, 0.69 to 0.91).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Among patients with type 2 diabetes receiving maintenance dialysis, GLP-1 RA initiation was associated with lower risk of cardiovascular events and all-cause mortality compared with other commonly prescribed antiglycemic agents.<\/jats:p>\n <\/jats:sec>\n \n Podcast<\/jats:title>\n This article contains a podcast at https:\/\/dts.podtrac.com\/redirect.mp3\/www.asn-online.org\/media\/podcast\/JASN\/2026_06_12_ASN0000001061.mp3<\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.0000001061","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T16:02:12Z","timestamp":1773331332000},"page":"1992-2003","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Cardiovascular Outcomes among New Users of GLP-1 Receptor Agonists Compared with DPP-4 Inhibitors and Sulfonylureas in Kidney Failure"],"prefix":"10.1681","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7734-6550","authenticated-orcid":false,"given":"Benjamin","family":"Catanese","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina"},{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5744-3038","authenticated-orcid":false,"given":"Cameron","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1127-1442","authenticated-orcid":false,"given":"Myles","family":"Wolf","sequence":"additional","affiliation":[{"name":"Weill Department of Medicine, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2589-6993","authenticated-orcid":false,"given":"Daniel","family":"Edmonston","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina"},{"name":"Duke Clinical Research Institute, Duke University School of 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