Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease.
<h4>Background</h4>Dulaglutide is associated with improved cardiovascular and kidney outcomes and can be a good therapeutic option for patients with type 2 diabetes with chronic kidney disease (CKD). In this study, the effects of dulaglutide on glucose-lowering efficacy and changes in re...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0273004 |
| _version_ | 1798003209605742592 |
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| author | Sungmin Kim Jung Nam An Young Rim Song Sung Gyun Kim Hyung Seok Lee AJin Cho Jwa-Kyung Kim |
| author_facet | Sungmin Kim Jung Nam An Young Rim Song Sung Gyun Kim Hyung Seok Lee AJin Cho Jwa-Kyung Kim |
| author_sort | Sungmin Kim |
| collection | DOAJ |
| description | <h4>Background</h4>Dulaglutide is associated with improved cardiovascular and kidney outcomes and can be a good therapeutic option for patients with type 2 diabetes with chronic kidney disease (CKD). In this study, the effects of dulaglutide on glucose-lowering efficacy and changes in renal function were analyzed.<h4>Methods</h4>This retrospective study involved 197 patients with type 2 diabetes with mild-to-severe CKD treated with dulaglutide for at least 3 months between January 2017 and December 2020 at two tertiary hospitals in Korea. Changes in the creatinine-based estimated glomerular filtration rate (eGFR) and HbA1c were compared before and after the use of dulaglutide in each patient.<h4>Results</h4>The number of patients and mean eGFR (mL/min/1.73 m2) in CKD 2, 3a, 3b, and 4 were 94 (75.0 ± 8.5), 46 (54.8 ± 6.3), 31 (38.8 ± 4.4), and 26 (22.5 ± 5.4), respectively. Mean HbA1c level and body mass index (BMI) at the initiation of dulaglutide were 8.9% ± 1.4% and 29.1 ± 3.6 kg/m2, the median duration of the use of dulaglutide was 16 months. The use of dulaglutide was associated with a mean decrease in HbA1c by 0.9% ± 1.5% and the glucose-lowering efficacy was similar across all stages of CKD. Also, it was associated with a reduced decline in the eGFR; the mean eGFR change after the use of dulaglutide was -0.76 mL/min/1.73 m2 per year, whereas it was -2.41 mL/min/1.73 m2 before use (paired t-test, P = 0.003). The difference was more pronounced in patients with an eGFR < 60 mL/min/1.73 m2. Subgroup analysis showed that the renal protective effect was better in patients with proteinuria, age ≤ 65 years, and HbA1c < 9.0%, but showed no association with BMI.<h4>Conclusions</h4>The use of dulaglutide provided adequate glycemic control irrespective of CKD stage and was associated with a reduced decline in the eGFR in the CKD population. |
| first_indexed | 2024-04-11T12:04:13Z |
| format | Article |
| id | doaj.art-a70f9af21712422989cee62921356196 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T12:04:13Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-a70f9af21712422989cee629213561962022-12-22T04:24:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01178e027300410.1371/journal.pone.0273004Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease.Sungmin KimJung Nam AnYoung Rim SongSung Gyun KimHyung Seok LeeAJin ChoJwa-Kyung Kim<h4>Background</h4>Dulaglutide is associated with improved cardiovascular and kidney outcomes and can be a good therapeutic option for patients with type 2 diabetes with chronic kidney disease (CKD). In this study, the effects of dulaglutide on glucose-lowering efficacy and changes in renal function were analyzed.<h4>Methods</h4>This retrospective study involved 197 patients with type 2 diabetes with mild-to-severe CKD treated with dulaglutide for at least 3 months between January 2017 and December 2020 at two tertiary hospitals in Korea. Changes in the creatinine-based estimated glomerular filtration rate (eGFR) and HbA1c were compared before and after the use of dulaglutide in each patient.<h4>Results</h4>The number of patients and mean eGFR (mL/min/1.73 m2) in CKD 2, 3a, 3b, and 4 were 94 (75.0 ± 8.5), 46 (54.8 ± 6.3), 31 (38.8 ± 4.4), and 26 (22.5 ± 5.4), respectively. Mean HbA1c level and body mass index (BMI) at the initiation of dulaglutide were 8.9% ± 1.4% and 29.1 ± 3.6 kg/m2, the median duration of the use of dulaglutide was 16 months. The use of dulaglutide was associated with a mean decrease in HbA1c by 0.9% ± 1.5% and the glucose-lowering efficacy was similar across all stages of CKD. Also, it was associated with a reduced decline in the eGFR; the mean eGFR change after the use of dulaglutide was -0.76 mL/min/1.73 m2 per year, whereas it was -2.41 mL/min/1.73 m2 before use (paired t-test, P = 0.003). The difference was more pronounced in patients with an eGFR < 60 mL/min/1.73 m2. Subgroup analysis showed that the renal protective effect was better in patients with proteinuria, age ≤ 65 years, and HbA1c < 9.0%, but showed no association with BMI.<h4>Conclusions</h4>The use of dulaglutide provided adequate glycemic control irrespective of CKD stage and was associated with a reduced decline in the eGFR in the CKD population.https://doi.org/10.1371/journal.pone.0273004 |
| spellingShingle | Sungmin Kim Jung Nam An Young Rim Song Sung Gyun Kim Hyung Seok Lee AJin Cho Jwa-Kyung Kim Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease. PLoS ONE |
| title | Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease. |
| title_full | Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease. |
| title_fullStr | Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease. |
| title_full_unstemmed | Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease. |
| title_short | Effect of once-weekly dulaglutide on renal function in patients with chronic kidney disease. |
| title_sort | effect of once weekly dulaglutide on renal function in patients with chronic kidney disease |
| url | https://doi.org/10.1371/journal.pone.0273004 |
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