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Study wrapper · #1120

Safety and efficacy of glucagon like peptide-1 receptor agonism-based therapies in end-stage renal disease: A systematic review and meta-analysis.

Dutta D, Jena S, Mahajan K, et al. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2026.

Editor's note

End-stage renal disease is exactly the population excluded from the pivotal incretin trials, so any pooled data here fills a genuine gap. The effect sizes look smaller than in the general obesity trials and the heterogeneity at twelve months is high enough to blunt confidence in the point estimates. The authors call their own findings hypothesis-generating and ask for prospective randomised trials, which is the right reading of 388 patients drawn largely from observational reports.

Plain-language abstract

The first systematic review and meta-analysis of GLP-1 receptor agonist therapy in end-stage renal disease pooled 388 patients across 19 studies, most of them on dialysis. Semaglutide was the most represented agent. Weight fell about 3.1 kg at three months, 3.7 kg at six months, and 7.0 kg at twelve months, with HbA1c down 0.75 points at a year. Adverse events were reported in 44% of semaglutide patients, mostly gastrointestinal, and 9% discontinued because of them.