Cardiovascular

Effects of GLP-1 receptor agonists on the incidence of contrast-induced acute kidney injury in patients with Type 2 diabetes mellitus undergoing coronary interventions.

Oksen D, Aslan M, et al. • Frontiers in endocrinology • 2026

PubMed 42723898 DOI 10.3389/fendo.2026.1930088

TL;DR

GLP-1 RA therapy was independently associated with a lower risk of CI-AKI in patients with T2DM undergoing contrast-based coronary procedures, with GLP-1 RA users showing significantly lower CI-AKI incidence (8.7% vs 25.7%) and higher post-procedural eGFR.

Key Findings

Results

CI-AKI occurred significantly less frequently among GLP-1 RA users compared to non-users in patients with T2DM undergoing coronary angiography or PCI.

CI-AKI incidence was 8.7% in GLP-1 RA users versus 25.7% in non-users (p<0.001).
CI-AKI was defined as a serum creatinine increase of ≥0.5 mg/dL or ≥25% from baseline within 72 hours.
The study included 336 patients total: 149 GLP-1 RA users and 187 non-users.
Patients received stable GLP-1 RA therapy prior to the procedure.

Results

GLP-1 RA use was independently associated with lower odds of CI-AKI after multivariable logistic regression adjustment.

Adjusted OR for CI-AKI with GLP-1 RA use was 0.290 (95% CI 0.119–0.708; p=0.007).
This represents approximately a 71% reduction in the odds of CI-AKI associated with GLP-1 RA use.
Multivariable logistic regression was used to identify independent predictors of CI-AKI.
The association remained significant after controlling for other covariates including age, baseline eGFR, and STEMI presentation.

Results

Post-procedural eGFR was significantly higher in the GLP-1 RA group compared to non-users at 48–72 hours after contrast exposure.

Mean eGFR at 48–72 hours was 67.1 ± 12.1 mL/min/1.73 m² in GLP-1 RA users versus 58.0 ± 11.8 mL/min/1.73 m² in non-users (p<0.001).
Post-procedural serum creatinine did not differ significantly between groups (1.02 ± 0.73 vs 1.17 ± 1.57 mg/dL, p=0.084).
Serum creatinine and eGFR were measured at baseline and again at 48–72 hours after the procedure.

Results

Increasing age and ST-segment elevation myocardial infarction (STEMI) presentation were independently associated with higher odds of CI-AKI.

Increasing age was associated with higher CI-AKI odds: OR 1.332 (95% CI 1.214–1.462; p<0.001).
STEMI presentation was associated with substantially higher CI-AKI odds: OR 5.039 (95% CI 2.368–10.722; p<0.001).
These were identified as independent predictors via multivariable logistic regression.

Results

Higher baseline eGFR was independently associated with lower odds of CI-AKI.

Higher baseline eGFR was associated with lower CI-AKI odds: OR 0.919 (95% CI 0.862–0.979; p=0.009).
This finding is consistent with known risk factors for contrast nephropathy, where pre-existing reduced kidney function increases vulnerability.
Baseline eGFR was one of several independent predictors identified in the multivariable model.

Methods

This was a retrospective cohort study of T2DM patients undergoing coronary angiography or PCI for acute coronary syndromes at a single center.

The study period was May 2023 to March 2025.
A total of 336 patients with T2DM were included: 149 GLP-1 RA users and 187 non-users.
Patients receiving stable GLP-1 RA therapy were compared with non-users.
The authors note findings require confirmation in prospective multicenter studies.

What This Means

This research suggests that patients with type 2 diabetes who were already taking GLP-1 receptor agonist medications (such as semaglutide or liraglutide) were significantly less likely to develop kidney injury after receiving contrast dye during heart procedures like coronary angiography or stenting. Among 336 diabetic patients studied, only about 1 in 12 GLP-1 RA users developed contrast-induced kidney injury compared to roughly 1 in 4 non-users. After accounting for other factors like age and kidney function, the use of GLP-1 RA medications was still strongly linked to a roughly 71% lower odds of developing this complication. The study also found that older age, having a heart attack caused by a completely blocked artery (STEMI), and already having reduced kidney function before the procedure were all factors that increased the risk of contrast-induced kidney injury. Patients on GLP-1 RAs also had better kidney function measurements 48–72 hours after the procedure, further supporting a potential protective effect on the kidneys from contrast exposure. This research suggests that GLP-1 receptor agonists may offer a protective benefit for the kidneys in diabetic patients undergoing heart procedures involving contrast dye, which is an important and common clinical scenario. However, since this was a retrospective single-center study, the authors caution that these findings are not yet definitive. Larger, prospective studies across multiple centers are needed to confirm whether this kidney-protective association is real and whether it should influence clinical practice decisions around GLP-1 RA therapy in this patient population.

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Citation

Oksen D, Aslan M, Yavuz Y, Kaynak C, Serin E. (2026). Effects of GLP-1 receptor agonists on the incidence of contrast-induced acute kidney injury in patients with Type 2 diabetes mellitus undergoing coronary interventions.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1930088

Key Findings

What This Means

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