Weight-loss drugs can improve kidney health, study finds | Drugs

Weight-loss drugs can reduce the risk of worsening kidney function, kidney failure and dying from kidney disease by a fifth, according to a study.

Glucagon-like peptide-1 (GLP-1) receptor agonists are a family of medications that help people shed the pounds, manage blood sugar in patients with type 2 diabetes and prevent heart attacks and strokes in people with heart disease.

But while the benefits of the drugs for treating obesity, type 2 diabetes and cardiovascular disease are well known, their potential impact on kidney health has been less certain.

Now the largest and most comprehensive analysis of GLP-1 receptor agonists on kidney outcomes suggests they could have significant benefits. The findings were published in the Lancet Diabetes & Endocrinology journal.

Researchers conducted a meta-analysis of 11 large-scale clinical trials of weight loss drugs involving more than 85,000 people. The group included people with type 2 diabetes, and people with cardiovascular disease who were overweight or obese but did not have type 2 diabetes.

Seven different GLP-1 receptor agonists were investigated among the trials, including semaglutide, also known as Ozempic or Wegovy, dulaglutide and liraglutide.

Compared with placebo, GLP-1 receptor agonists reduced the risk of kidney failure by 16% and the worsening of kidney function by 22%, researchers said. The combined reduction in the risk of kidney failure, worsening kidney function and death due to kidney disease was 19%.

The analysis also confirmed previous findings that weight-loss drugs protect cardiovascular health, with a 14% reduction in the risk of cardiovascular death, non-fatal heart attack and non-fatal stroke, compared with placebo. Death by any cause was 13% lower among patients treated with GLP-1 receptor agonists.

Lead author Prof Sunil Badve, professorial fellow at the George Institute for Global Health and UNSW Sydney, said the study expanded current knowledge about the potential benefits of the drugs.

“This is the first study to show a clear benefit of GLP-1 receptor agonists on kidney failure or end-stage kidney disease, suggesting they have a key role in kidney-protective and heart-protective treatment for patients with common medical conditions like type 2 diabetes, overweight or obesity with cardiovascular disease, or CKD [chronic kidney disease],” he said.

“These results are particularly important for patients with chronic kidney disease. It is a progressive condition eventually leading to kidney failure requiring dialysis or kidney transplantation and is associated with premature death, mostly from heart disease. It has a significant impact on patients’ quality of life and incurs substantial healthcare costs.”

CKD is estimated to affect one in 10 people worldwide, equivalent to about 850 million people. It is the 10th leading cause of death and is projected to become the fifth most common cause of death by 2050.

Prof Vlado Perkovic, professorial fellow at the George Institute, provost at UNSW Sydney and senior author on the study, said: “This research shows that GLP-1 receptor agonists could play an important role in addressing the global burden of non-communicable diseases.

“Our study will have a major impact on clinical guidelines for the management of chronic kidney disease and cardiovascular disease in people with and without diabetes.

“More work is now needed to implement the results of this study into clinical practice and improve access to GLP-1 receptor agonists to people who will benefit from them.”