{
  "abstract": "Background: Use of GLP-1 receptor agonists (GLP-1 RAs) is an established therapy that delays progression of chronic kidney disease in type 2 diabetes mellitus (T2DM), but their impact on lithium-associated nephrotoxicity is unclear. We evaluated whether GLP-1 RA use is associated with reduced renal risk in adults receiving long-term lithium therapy.\n\nMethods: We conducted a retrospective, propensity score-matched cohort study using TriNetX electronic health records (>127 million patients across 109 healthcare organizations). Adults (≥18 years) with T2DM and lithium exposure within 2 years prior to index were included. The primary outcome was renal nephrotoxicity, defined as a composite of ICD-10 and CPT-coded renal disease. Incidence and time-to-event outcomes were assessed using Kaplan–Meier curves and Cox proportional hazards models.\n\nResults: In a 24-month analysis of 452 matched patient pairs, GLP-1 RA initiation during lithium therapy was associated with a marked reduction in renal events versus lithium alone (23.5% vs 44.7%), corresponding to a risk difference of −21.2% (95% CI -36.9 to −5.5) and a risk ratio of 0.53 (95% CI 0.30–0.91; p = 0.013). Event-free survival was higher (62.5% vs 43.4%; log-rank p = 0.0115), with a hazard ratio of 0.45 (95% CI 0.23–0.85; p = 0.0089). This represents a 47% relative risk reduction and a number needed to treat (NNT) of 5 over 24 months.\n\nConclusion: These findings support further mechanistic and prospective studies of GLP-1 RAs as a renoprotective strategy for patients receiving lithium treatment.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychiatry, University of Toronto, Canada",
    "Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University Norton College of Medicine, USA",
    "Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA",
    "Brain and Cognition Discovery Foundation, Canada",
    "University of Toronto, Canada"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Roger S. McIntyre",
      "orcid": "0000-0003-4733-2523"
    },
    {
      "affs": [
        1
      ],
      "name": "Yanli Zhang-James"
    },
    {
      "affs": [
        2
      ],
      "name": "Joseph F. Goldberg"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Angela T.H. Kwan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cctkqss0ph19k.bib",
  "cited_by": 3,
  "doi": "10.1017/s1092852926101023",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13732603/",
  "id": "cctkqss0ph19k",
  "issns": [
    "1092-8529",
    "2165-6509"
  ],
  "landing_url": "https://doi.org/10.1017/s1092852926101023",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2712|Diabetes Treatment and Management"
    ]
  ],
  "openalex": "W7163997542",
  "pdf_url": "https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D2A1E27286B4408377570220E3CD5DCB/S1092852926101023a.pdf/div-class-title-nephroprotective-effects-of-glp-1-receptor-agonists-in-lithium-treated-patients-a-multinational-cohort-study-using-the-trinetx-network-div.pdf",
  "pmcid": "PMC13732603",
  "pmid": "42261766",
  "published": "2026-06-09",
  "publisher": "Cambridge University Press",
  "ris": "https://research.draconitic.com/paper/cctkqss0ph19k.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:34Z",
      "native_id": "PMC13732603",
      "source": "pmc",
      "url": "https://doi.org/10.1017/s1092852926101023"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Treatment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Nephroprotective effects of GLP-1 receptor agonists in patients receiving lithium treatment: a multinational cohort study using the TriNetX network",
  "title_text": "Nephroprotective effects of GLP-1 receptor agonists in patients receiving lithium treatment: a multinational cohort study using the TriNetX network",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:34Z",
  "url": "https://research.draconitic.com/paper/cctkqss0ph19k",
  "venue": "CNS Spectrums",
  "versions": []
}