{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:50:56Z","timestamp":1791471056941,"version":"4.3.4"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"\n Key Points<\/jats:title>\n \n \n \n Glucagon-like peptide-1 receptor agonist have shown clinical benefits in patients with chronic kidney disease, but there are no randomized trials to support their efficacy in ESKD.<\/jats:p>\n <\/jats:list-item>\n \n This matched retrospective cohort study used electronic health record from a dialysis provider and was conducted in diabetic, incident in-center hemodialysis patients.<\/jats:p>\n <\/jats:list-item>\n \n Results indicated that continued use of glucagon-like peptide-1 receptor agonist is associated with a 9% lower hospitalization and a 17% lower mortality rate.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n The recent clinical trial FLOW showed that semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), reduced the risk of clinical outcomes and death from cardiovascular causes in patients with CKD and type 2 diabetes. Given the substantial benefit to patients with CKD, the question remains whether these drugs benefit patients with ESKD. We sought to evaluate the impact of GLP-1 RA use in patients with incident ESKD on clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Patients included in this matched retrospective cohort study were adult patients with ESKD who initiated thrice-weekly in-center hemodialysis at a kidney care organization between January 2018 and April 2024. Using internal electronic health record data, eligible patients who initiated dialysis on a GLP-1 RA (with evidence of a GLP-1 RA prescription in the first 30 days after dialysis initiation;\n n<\/jats:italic>\n =2492) were matched 1:1 to those not on a prescription. Patients were followed from index date until death or the end of the study (July 31, 2024). Incident rate ratios were estimated using a negative binomial distribution with a random intercept to account for the matched nature of the data.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Patients with a GLP-1 RA prescription in the first month of dialysis had a mean\u00b1SD age of 63\u00b112 years and were predominately male (59%). Compared with other eligible dialysis patients, nearly all patients on a GLP-1 RA had a known diagnosis of diabetes (98% versus 73%), a majority had evidence of predialysis nephrology care (76% versus 67%), were of White race (46% versus 39%), and had a mean\u00b1SD body mass index of 33\u00b18 kg\/m\n 2<\/jats:sup>\n (versus 30\u00b18). After matching and adjustment, GLP-1 RAs were independently associated with lower hospitalization (incidence rate ratios, 0.91 [0.87 to 0.96]) and mortality (Incidence rate ratios, 0.83 [0.73 to 0.95]) rates.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Among incident in-center hemodialysis patients, GLP-1 RA use was independently associated with a 9% lower hospitalization rate and a 17% lower mortality rate.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000001208","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:01:17Z","timestamp":1787673677000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Glucagon-Like Peptide-1 Receptor Agonist Use and Risks of Hospitalization and Mortality in Patients with ESKD"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8065-0710","authenticated-orcid":false,"given":"Steph","family":"Karpinski","sequence":"first","affiliation":[{"name":"DaVita, Inc., Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwan","family":"Qazi","sequence":"additional","affiliation":[{"name":"Kidney Specialists of Southern Nevada, Las Vegas, Nevada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence","family":"Bjordahl","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Sibbel","sequence":"additional","affiliation":[{"name":"DaVita, Inc., Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8016-2015","authenticated-orcid":false,"given":"Eric","family":"Weinhandl","sequence":"additional","affiliation":[{"name":"DaVita, Inc., Denver, Colorado"},{"name":"Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Tentori","sequence":"additional","affiliation":[{"name":"DaVita, Inc., Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Brunelli","sequence":"additional","affiliation":[{"name":"DaVita, Inc., Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"4","key":"B1-20261008","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1056\/NEJMoa1603827","article-title":"Liraglutide and cardiovascular outcomes in type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med."},{"issue":"2","key":"B2-20261008","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med."},{"issue":"24","key":"B4-20261008","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","article-title":"Semaglutide and cardiovascular outcomes in obesity without diabetes","volume":"389","author":"Lincoff","year":"2023","journal-title":"N Engl J Med."},{"issue":"8","key":"B5-20261008","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.2215\/CJN.0000000750","article-title":"GLP-1 receptor agonist outcomes, safety, and body mass index change in a national cohort of patients on dialysis","volume":"20","author":"Orandi","year":"2025","journal-title":"Clin J Am Soc Nephrol."},{"issue":"4","key":"B6-20261008","doi-asserted-by":"crossref","first-page":"947","DOI":"10.3390\/jcm9040947","article-title":"GLP-1 receptor agonists and diabetic kidney disease: a call of attention to nephrologists","volume":"9","author":"G\u00f3rriz","year":"2020","journal-title":"J Clin Med."},{"issue":"suppl 1","key":"B7-20261008","doi-asserted-by":"crossref","first-page":"2S20","DOI":"10.1016\/S1262-3636(17)30069-1","article-title":"The potential and pitfalls of GLP-1 receptor agonists for renal protection in type 2 diabetes","volume":"43","author":"Thomas","year":"2017","journal-title":"Diabetes Metab."},{"issue":"6","key":"B8-20261008","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3390\/medicina55060233","article-title":"GLP-1 receptor agonists and kidney protection","volume":"55","author":"Greco","year":"2019","journal-title":"Medicina (Kaunas)."},{"key":"B9-20261008","doi-asserted-by":"crossref","first-page":"1446468","DOI":"10.3389\/fcvm.2024.1446468","article-title":"Anti-inflammatory effects of glucagon-like peptide-1 (GLP-1) in coronary artery disease: a comprehensive review","volume":"11","author":"Skrobucha","year":"2024","journal-title":"Front Cardiovasc Med."},{"issue":"8","key":"B10-20261008","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1111\/dom.13761","article-title":"Effect of liraglutide on estimates of lipolysis and lipid oxidation in obese patients with stable coronary artery disease and newly diagnosed type 2 diabetes: a randomized trial","volume":"21","author":"Anholm","year":"2019","journal-title":"Diabetes Obes Metab."},{"issue":"1","key":"B11-20261008","doi-asserted-by":"crossref","first-page":"5002","DOI":"10.1038\/s41598-024-55724-z","article-title":"The impact of GLP-1 receptor agonist liraglutide on blood pressure profile, hydration, natriuresis in diabetic patients with severely impaired kidney function","volume":"14","author":"Wajdlich","year":"2024","journal-title":"Sci Rep."},{"issue":"1","key":"B12-20261008","doi-asserted-by":"crossref","first-page":"e001986","DOI":"10.1136\/bmjopen-2012-001986","article-title":"Effects of exenatide and liraglutide on heart rate, blood pressure and body weight: systematic review and meta-analysis","volume":"3","author":"Robinson","year":"2013","journal-title":"BMJ Open."},{"issue":"1","key":"B13-20261008","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.diabres.2015.07.015","article-title":"Impact of GLP-1 receptor agonists on blood pressure, heart rate and hypertension among patients with type 2 diabetes: a systematic review and network meta-analysis","volume":"110","author":"Sun","year":"2015","journal-title":"Diabetes Res Clin Pract."},{"issue":"4","key":"B14-20261008","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.cmet.2018.03.001","article-title":"Mechanisms of action and therapeutic application of glucagon-like Peptide-1","volume":"27","author":"Drucker","year":"2018","journal-title":"Cell Metab."},{"issue":"5s","key":"B15-20261008","first-page":"S1","article-title":"Clinical Practice Guideline for diabetes management in chronic kidney disease","volume":"102","year":"2022","journal-title":"Kidney Int."},{"issue":"1","key":"B16-20261008","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1681\/ASN.0000000000000477","article-title":"Sodium-Glucose Cotransporter-2 inhibitor and glucagon-like Peptide-1 receptor agonist discontinuation in patients with CKD","volume":"36","author":"Gregg","year":"2025","journal-title":"J Am Soc Nephrol."},{"issue":"1","key":"B17-20261008","doi-asserted-by":"crossref","first-page":"e2457349","DOI":"10.1001\/jamanetworkopen.2024.57349","article-title":"Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists among US adults with overweight or obesity","volume":"8","author":"Rodriguez","year":"2025","journal-title":"JAMA Netw Open."},{"key":"B18-20261008","doi-asserted-by":"crossref","first-page":"403","DOI":"10.2147\/DMSO.S141235","article-title":"Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes","volume":"10","author":"Sikirica","year":"2017","journal-title":"Diabetes Metab Syndr Obes Targets Ther."},{"issue":"11","key":"B19-20261008","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1001\/jamacardio.2025.3109","article-title":"Discontinuation of semaglutide among older adults with diabetes in the US and Japan","volume":"10","author":"Inoue","year":"2025","journal-title":"JAMA Cardiol."},{"issue":"8","key":"B20-20261008","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/dom.14725","article-title":"Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension","volume":"24","author":"Wilding","year":"2022","journal-title":"Diabetes Obes Metab."},{"issue":"1","key":"B21-20261008","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1001\/jama.2023.24945","article-title":"Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial","volume":"331","author":"Aronne","year":"2024","journal-title":"JAMA."},{"issue":"8","key":"B22-20261008","doi-asserted-by":"crossref","first-page":"e13929","DOI":"10.1111\/obr.13929","article-title":"Discontinuing glucagon-like peptide-1 receptor agonists and body habitus: a systematic review and meta-analysis","volume":"26","author":"Berg","year":"2025","journal-title":"Obes Rev."}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:00:56Z","timestamp":1791468056000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":21,"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001208","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2026-04-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}