Premium
The effect of liraglutide on renal function: A randomized clinical trial
Author(s) -
von Scholten Bernt J.,
Persson Frederik,
Rosenlund Signe,
Hovind Peter,
Faber Jens,
Hansen Tine W.,
Rossing Peter
Publication year - 2017
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12808
Subject(s) - liraglutide , albuminuria , medicine , urology , renal function , placebo , endocrinology , type 2 diabetes , diabetes mellitus , creatinine , alternative medicine , pathology
Aims Among patients with type 2 diabetes and albuminuria, cardiorenal morbidity and mortality are high despite multifactorial treatment. Short‐term reduction in albuminuria is considered suggestive of long‐term renoprotective effects. We evaluated the renal effects of the glucagon‐like peptide‐1 ( GLP ‐1) receptor agonist liraglutide on top of multifactorial care, including renin‐angiotensin‐system ( RAS )‐inhibition. Materials and methods Randomized, double‐blind, placebo‐controlled, cross‐over trial including patients with type 2 diabetes and persistent albuminuria (urinary albumin‐to‐creatinine ratio >30 mg/g) and estimated glomerular filtration rate ( eGFR ) ≥30 mL /min/1.73 m 2 . Patients received liraglutide (1.8 mg/d) and matched placebo for 12 weeks in a random order. The primary endpoint was change in 24‐h urinary albumin excretion rate ( UAER ). Results A total of 32 patients were randomized and 27 completed the study. After placebo treatment, geometric mean ( IQR ) UAER was 199 (81‐531) mg/24‐h, mean ( SD ) measured GFR ( mGFR ) 75 (36) mL /min/1.73 m 2 , 24‐h blood pressure 145/80 (15/8) mm Hg and HbA1c 61 (11) mmol/mol. Liraglutide reduced HbA1c by 8 (95% CI : 5; 11) mmol/mol ( P < .001) and weight by 1.8 (95% CI : 0.2; 3.4) kg ( P = .032) compared to placebo. Furthermore, liraglutide reduced UAER by 32 (95% CI : 7; 50)% ( P = .017) compared with placebo. The change in mGFR was −5 (95% CI : −11; 2) mL /min/1.73 m 2 ( P = .15), and change in 24‐h systolic blood pressure was −5 (95% CI : −10; 0) mm Hg ( P = .07). In multivariate regression models, change in UAER was associated with change in 24‐h systolic blood pressure ( P = .025) but not with change in HbA1c , weight or mGFR ( P ≥ .14), overall model R 2 = .39. Conclusions Our placebo‐controlled randomized trial suggests that liraglutide has renoprotective effects on top of multifactorial treatment, including RAS ‐inhibition, in patients with type 2 diabetes and albuminuria.