A recent study led by researchers at Vanderbilt University Medical Center indicates that glucagon-like peptide-1 (GLP-1) receptor agonists, commonly used as blockbuster obesity drugs, may also protect the kidneys and slow the progression of kidney disease. The findings, stemming from a gene-association study involving over 350,000 participants in the Million Veteran Program (MVP), suggest a potential new avenue for kidney disease treatment.
The study, published in JAMA Network Open, revealed that higher expression of the GLP1R gene, which encodes the GLP-1 receptor, was associated with a lower risk of kidney disease progression. This observation aligns with previous clinical trials demonstrating the efficacy of semaglutide, a GLP-1 receptor agonist, in reducing kidney disease progression among patients with type 2 diabetes and chronic kidney disease.
Broader Implications for Kidney Care
"These findings are exciting because they suggest GLP-1 receptor agonists could have broader kidney-protective effects than initially thought," said Jefferson Triozzi, MD, MSCI, the paper’s first author and instructor in Medicine at VUMC. Adriana Hung, MD, MPH, professor of Medicine at VUMC and medical director of dialysis services at the Nashville VA Medical Center, added that these drugs could potentially become part of the standard medical therapy for preventing kidney disease progression, extending beyond the context of diabetes.
The Need for Further Research
While the results are promising, Hung emphasized the importance of conducting more clinical studies to validate these findings across diverse patient groups. This includes emulation trials to evaluate the effect of GLP-1 receptor agonists in subgroups of the population typically underrepresented in large trials.
The Burden of Chronic Kidney Disease
According to the National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 37 million Americans suffer from chronic kidney disease. Diabetes and high blood pressure are the leading causes of kidney disease, which can progress to kidney failure requiring dialysis or a kidney transplant if left untreated.
Hung and her colleagues have been instrumental in elucidating the role of genetic and environmental factors, including inflammation and insulin resistance, in the development of chronic kidney disease. As a local site principal investigator for the MVP program and principal investigator of an MVP grant exploring the genetics of kidney disease and hypertension, Hung's work is at the forefront of kidney disease research.
Future Directions in Kidney Disease Treatment
"These are exciting times for kidney care providers," Hung stated, highlighting the unparalleled opportunity to improve patient outcomes through the incorporation of new therapeutics targeting metabolic disturbances associated with chronic kidney disease. The study was conducted in collaboration with researchers from Brigham and Women’s Hospital, the MVP Coordinating Center in Boston, the Atlanta VA Health Care System, and Emory University School of Medicine.
