The Effect of GLP-1 Receptor Agonist as Add-on Therapy to SGLT-2 Inhibitor on Albuminuria in Type 2 Diabetes with Chronic Kidney Disease
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Abstract
Background: The effectiveness GLP-1 receptor agonist as an add-on therapy to SGLT-2 inhibitor in reducing albuminuria in diabetic kidney disease remains largely underexplored. This trial aims to evaluate the impact of this dual therapy compared to SGLT-2 inhibitor alone on albuminuria reduction over 6 months in patients with type 2 diabetes and chronic kidney disease
Methods: This retrospective cohort study included patients with type 2 diabetes and albuminuria between January 2018 and December 2023. A total of 122 patients who received either SGLT-2 inhibitors alone or in combination with GLP-1 receptor agonists were included. The primary outcome was the difference in the mean percent change in the urine albumin-to-creatinine ratio (UACR) at 6 months. Secondary outcomes included changes in HbA1c, blood pressure, body weight, serum creatinine, estimated glomerular filtration rate (eGFR), and adverse events.
Results: The mean percent change in UACR from baseline was 7.26% (-21.84, 36.36) in the SGLT-2 inhibitor group and -5.43% (-28.1, 17.25) in the combination therapy group. The between-group difference was -12.7% (-48.8, 23.4) (P=0.491). While the combination group showed a trend toward HbA1c and blood pressure reductions, these differences did not reach statistical significance. Neither group had significant changes in body weight, serum creatinine, or eGFR. Adverse events were similar between the two groups.
Conclusion: Adding GLP-1 receptor agonist to SGLT-2 inhibitor did not significantly reduce albuminuria, blood pressure, or HbA1C after 6 months of follow-up in patients with diabetic kidney disease.
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