{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:41:32Z","timestamp":1791250892751,"version":"4.1.0"},"reference-count":73,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["K01DK132490"],"award-info":[{"award-number":["K01DK132490"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["K24AI144954"],"award-info":[{"award-number":["K24AI144954"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Mid-America Transplant\/Jane A. Beckman endowed chair in transplantation"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>GLP-1 receptor agonists (GLP-1 RAs) in diabetes and dialysis are associated with 23% lower mortality and 66% higher chance of transplant waitlisting.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>GLP-1 RAs are not associated with increased risk of acute pancreatitis, biliary complications, or medullary thyroid cancer.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>GLP-1 RAs are associated with a 32% increased risk of diabetic retinopathy in patients with diabetes on dialysis.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Of the 808,000 US patients on dialysis, 60% have diabetes and are eligible for glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Safety and outcomes in this population are unknown. We sought to examine GLP-1 RA real-world safety, efficacy, and weight loss in people with diabetes on dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this observational national cohort study (2013\u20132021), we identified adults with type 2 diabetes on dialysis. The exposure of interest was GLP-1 RA use. Body mass index (BMI) change after dialysis initiation was quantified among patients with two measurements (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      =6474). Extended Cox models with inverse probability of treatment weights (censoring for kidney transplant waitlisting) were used to quantify all-cause mortality associated with GLP-1 RAs. Specific safety outcomes (acute pancreatitis, biliary complications, medullary thyroid cancer, and diabetic retinopathy) were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 151,649 patients on incident dialysis with type 2 diabetes. Mean BMI and weight change among GLP-1 RA users were greater than those among nonusers (\u22121.47 versus \u22120.61 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; \u22124.03 versus \u22121.47 kg;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001 for both). The mortality incidence rate was lower among GLP-1 RA users (219.0 versus 279.5 patients\/1000 person-years;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). GLP-1 RA use was associated with a 23% lower risk of mortality (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.70 to 0.85;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); results were consistent among initiates with BMI \u226530 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . GLP-1 RA use was associated with a 66% higher chance of waitlisting (aHR, 1.66; 95% CI, 1.28 to 2.13;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). There was an increased association with diabetic retinopathy (aHR, 1.32; 95% CI, 1.12 to 1.56;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001), but not with any other safety outcomes. Inferences were consistent across multiple sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GLP-1 RA use in patients with type 2 diabetes on dialysis was associated with weight loss, reduced mortality risk, and increased likelihood of kidney transplant waitlisting. These real-world data are the strongest evidence to date supporting GLP-1 RA use in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000750","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T12:02:40Z","timestamp":1750161760000},"page":"1100-1110","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":35,"title":["GLP-1 Receptor Agonist Outcomes, Safety, and Body Mass Index Change in a National Cohort of Patients on Dialysis"],"prefix":"10.2215","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-7135","authenticated-orcid":false,"given":"Babak J.","family":"Orandi","sequence":"first","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"},{"name":"Department of Medicine, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6968-4664","authenticated-orcid":false,"given":"Yusi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6279-5740","authenticated-orcid":false,"given":"Yiting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7695-3583","authenticated-orcid":false,"given":"David","family":"Charyton","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-4849","authenticated-orcid":false,"given":"Krista L.","family":"Lentine","sequence":"additional","affiliation":[{"name":"Department of Medicine, Saint Louis University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2108-1287","authenticated-orcid":false,"given":"Brian P.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University, New York, New York"},{"name":"Department of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario P.","family":"DeMarco","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-9184","authenticated-orcid":false,"given":"Michael A.","family":"Weintraub","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-8816","authenticated-orcid":false,"given":"Sunjae","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0973-1657","authenticated-orcid":false,"given":"Bonnie E.","family":"Lonze","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine J.","family":"Ren-Fielding","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3403-882X","authenticated-orcid":false,"given":"Holly","family":"Lofton","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4250-9086","authenticated-orcid":false,"given":"Akash","family":"Gujral","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4801","authenticated-orcid":false,"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"},{"name":"Department of Population Health, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-925X","authenticated-orcid":false,"given":"Mara","family":"McAdams-DeMarco","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University, New York, New York"},{"name":"Department of Population Health, New York University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"issue":"6","key":"B1-20250808","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa2107519","article-title":"Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes","volume":"385","author":"Fr\u00edas","year":"2021","journal-title":"N Engl J 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