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Original

Real world, retrospective experience of glucagon-like peptide-1 receptor agonists in kidney transplant recipients: A single-center case series 

Priyamvada Singh, Melissa McGowan, Lauren Von Stein, Johanna Papanikolla, Annelise Nolan, Hannah Lingren, Noah Jagielski, Navdeep Singh, Shumei Meng, and Todd Pesavento

Volume 105 (2026) p. 318 - 324

Abstract

Clinical Nephrology, Vol. 105 – No. 5/2026 (318-324)

Real world, retrospective experience of glucagon-like peptide-1 receptor agonists in kidney transplant recipients: A single-center case series 

Priyamvada Singh, Melissa McGowan, Lauren Von Stein, Johanna Papanikolla, Annelise Nolan, Hannah Lingren, Noah Jagielski, Navdeep Singh, Shumei Meng, and Todd Pesavento

Comprehensive Transplant Center, Ohio State University, Columbus, OH, USA
We conducted a retrospective chart review of adult kidney transplant recipients (KTxR) with type 2 diabetes treated with a glucagon-like peptide-1 receptor agonist (GLP-1RA). A total of 211, 207, 161, and 92 KTxR were followed for 6, 12, 36, and 60 months, respectively. Over 5 years, we observed statistically significant reductions in the primary endpoints of weight, HbA1c, and major adverse cardiovascular events (MACE). The mean weight reduction was as follows: 1.17 kg at 6 months (p < 0.006), 1.2 kg at 12 months (p < 0.03), 3.7 kg at 36 months (p < 0.0001), and 4.1 kg at 60 months (p = 0.001) compared to baseline. The HbA1c levels showed reductions of 0.6 mmol/mol at 6 months (p < 0.0001), 0.5 mmol/mol at 12 months (p = 0.0004), 0.3 mmol/mol at 36 months (p = 0.04), and 0.35 mmol/mol at 60 months (p = 0.35). MACE rates fell from 45.5% at GLP-1RA initiation to 18.9% during follow-up (OR 3.6 (2.3 – 5.6), p < 0.0001). Insulin requirements decreased from 50 to 27 units over 5 years. Kidney function reduces over time in KTx, likely secondary to hemodynamic or vascular-mediated risk factors, chronic immunosuppressive agents, treatment for rejections, and solitary transplanted kidney. In our study, estimated glomerular filtration rate (eGFR) not only stayed stable but also showed a trend towards improvement (eGFR improved from 50 to 53 mL/min/1.73m²). Further prospective randomized trials are needed to assess GLP-1RA efficacy and safety in KTxR.Correspondence to:
Priyamvada Singh, MBBS, FASN
Division of Nephrology and Comprehensive Transplant Center
Ohio State University
395 W 12 Avenue
Columbus, OH 43210, USA
Email: [email protected]

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