Kidney Medicine | 2021
Glucagon-like Peptide-1 Receptor Agonists and the Risk of Acute Kidney Injury: Alarming, or Not?
Abstract
Glucagon-like Peptide-1 Receptor Agonists and the Risk of Acute Kidney Injury: Alarming, or Not? To the Editor: We read with interest the 2 case reports of acute kidney injury (AKI) associated with semaglutide use, described by Leehey et al, given the risks associated with AKI. In light of the reported kidney benefits of glucagon-like peptide-1 receptor agonists (GLP-1RAs), we investigated whether GLP-1RAs are associated with increased risk for AKI, pooling data from cardiovascular outcome trials that enrolled highor very-high-risk individuals with type 2 diabetes mellitus. We set as primary safety outcome the incidence of AKI. Two independent reviewers (DP and AB) extracted data from eligible reports using a pilot tested data extraction form. Differences were calculated with the use of risk ratio (RR) after implementation of the Mantel-Haenszel random effects formula. Statistical heterogeneity among studies was assessed by using I statistics. Analyses were performed using RevMan 5.3 software. Discrepancies between reviewers were solved by discussion, consensus, or arbitration by a third senior reviewer (MD). Pooled data from 7 cardiovascular outcome trials with GLP-1RAs provided a total of 55,943 patients. Risk of bias was low across all selected trials. GLP-1RA treatment resulted in a nonsignificant decrease in risk for AKI (RR = 0.96; 95% CI: 0.82 to 1.14; Fig 1). When restricting