Target Trial of Glucagon-Like Peptide-1 Agonists versus Dipeptidyl Peptidase-4 Inhibitors and Mortality in Hemodialysis.
Publication/Presentation Date
8-1-2026
Abstract
INTRODUCTION: The comparative effectiveness of glucagon-like peptide-1 (GLP-1) agonists (GLP-1s) versus dipeptidyl peptidase-4 (DPP-4) inhibitors (DPP-4s) in hemodialysis is unknown.
METHODS: Using 2011 to 2021 US Renal Data System and Medicare claims data, we emulated a target trial comparing new users of GLP-1s versus DPP-4s with patients who survived ≥ 90 days on in-center hemodialysis before medication initiation. We used inverse probability of treatment weighting (IPTW) and Cox proportional hazards models to estimate hazard ratios (HRs).
RESULTS: We identified 3671 GLP-1 and 12,039 DPP-4 users. After IPTW, mean age was 63 years, 52% male, 63% White, and mean body mass index was 31 kg/m
CONCLUSION: GLP-1 (vs. DPP-4) initiation was not associated with reduced mortality in intention-to-treat analysis, but continuous use was associated with improved survival. The therapeutic potential of GLP-1s among patients receiving hemodialysis may be limited by medication discontinuation.
Volume
11
Issue
8
First Page
106618
Last Page
106618
ISSN
2468-0249
Published In/Presented At
Le, D., Kilpatrick, M., Kraft, W. K., Grams, M. E., Jaar, B. G., & Shin, J. I. (2026). Target Trial of Glucagon-Like Peptide-1 Agonists versus Dipeptidyl Peptidase-4 Inhibitors and Mortality in Hemodialysis. Kidney international reports, 11(8), 106618. https://doi.org/10.1016/j.ekir.2026.106618
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
42381765
Department(s)
Administration and Leadership
Document Type
Article