Lai Hsuan-Wen, Chen Jui-Yi, Wu Vin-Cent, See Chun Yin
School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Centre, Tainan, Taiwan.
Cardiovasc Diabetol. 2025 Mar 8;24(1):110. doi: 10.1186/s12933-024-02543-1.
The 2022 KDIGO guideline for diabetes management in patients with chronic kidney disease (CKD) had endorsed the use of GLP-1 receptor agonists (GLP-1RAs) for patients with CKD and type 2 diabetes who did not achieve optimal glycemic target with maximally tolerated metformin and sodium-glucose co-transporter-2 (SGLT-2) inhibitor. Our study revealed the potential benefits of GLP-1RAs in patients with dialysis-requiring acute kidney disease possibly owing to pleiotropic effects of the medicine. Nonetheless, pharmacokinetics and dialysis dose were omitted in our subgroup analyses. Herein, we would like to raise our concern regarding neglecting these important confounders in our analyses and the impact to the findings of the study.
2022年改善全球肾脏病预后组织（KDIGO）慢性肾脏病（CKD）患者糖尿病管理指南认可，对于使用最大耐受剂量二甲双胍和钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂仍未达到最佳血糖目标的CKD合并2型糖尿病患者，可使用胰高血糖素样肽-1受体激动剂（GLP-1RAs）。我们的研究揭示了GLP-1RAs对需要透析的急性肾疾病患者的潜在益处，这可能归因于该药物的多效性作用。尽管如此，我们的亚组分析中未涉及药代动力学和透析剂量。在此，我们想对分析中忽略这些重要混杂因素及其对研究结果的影响表示关注。
