Skip to content
DraconiticResearch
Search Sources API
197,693 studies31 sourcesUpdated 7 min ago
Peer-reviewedCC BY 4.0CNS Spectrums

Nephroprotective effects of GLP-1 receptor agonists in patients receiving lithium treatment: a multinational cohort study using the TriNetX network

  • Roger S. McIntyre1
  • Yanli Zhang-James2
  • Joseph F. Goldberg3
  • Angela T.H. Kwan4,5
5 affiliations
  1. 1Department of Psychiatry, University of Toronto, Canada
  2. 2Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University Norton College of Medicine, USA
  3. 3Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA
  4. 4Brain and Cognition Discovery Foundation, Canada
  5. 5University of Toronto, Canada
Read full textPDFDOICite

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.

Methods: 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.

Results: 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.

Conclusion: These findings support further mechanistic and prospective studies of GLP-1 RAs as a renoprotective strategy for patients receiving lithium treatment.

Related

  1. Comparative Short-Term Risk of Severe Gastrointestinal Events Associated with Opioid Type Among Patients Receiving Glucagon-Like Peptide-1 Receptor Agonists
    Sungho Bea, Elisabetta Patorno, Sushama Kattinakere Sreedhara +5
    Diabetes carePeer-reviewedLicence not statedFull textEpidemiology & public healthPMC
  2. Gastric residual volume in patients with obesity receiving GLP-1 receptor agonists: A comparative gastric ultrasound pilot study.
    Abdulaziz Ejaz Ahmad, Nada Tariq Yamani, Abdulaziz Fahad Alaqaili +3
    Saudi journal of anaesthesiaPeer-reviewedCC BY-NC-SAFull textGeneral medicineEurope PMCPMC
  3. Modern Obesity Treatment: Efficacy, Safety, and Future Directions of GLP-1 (Glucagon-Like Peptide-1) and GIP (Glucose-Dependent Insulinotropic Polypeptide) Receptor Agonists
    Dorota Bartkowiak, Barlomiej Jakubczyk, Adam Lasota +7
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  4. Determinants of variable response to GLP-1 receptor agonists: A mechanism-informed framework for precision treatment of obesity.
    Samit Ghosal
    Obesity pillarsPeer-reviewedCC BY-NC-NDFull textPharmacology & toxicologyEurope PMC
  5. Treatment patterns and safety outcomes after splenectomy or thrombopoietin receptor agonists as second-line therapy for immune thrombocytopenia: Korean claims-based study.
    Hyung-Jun Lim, Kunye Kwak, Changgon Kim +5
    Research and practice in thrombosis and haemostasisPeer-reviewedCC BYFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{mcintyre2026nephroprotective,
  title = {{Nephroprotective effects of GLP-1 receptor agonists in patients receiving lithium treatment: a multinational cohort study using the TriNetX network}},
  author = {Roger S. McIntyre and Yanli Zhang-James and Joseph F. Goldberg and Angela T.H. Kwan},
  journal = {CNS Spectrums},
  year = {2026},
  month = jun,
  doi = {10.1017/s1092852926101023},
  url = {https://doi.org/10.1017/s1092852926101023},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Nephroprotective effects of GLP-1 receptor agonists in patients receiving lithium treatment: a multinational cohort study using the TriNetX network
AU  - Roger S. McIntyre
AU  - Yanli Zhang-James
AU  - Joseph F. Goldberg
AU  - Angela T.H. Kwan
PY  - 2026
DA  - 2026/06/09
JO  - CNS Spectrums
DO  - 10.1017/s1092852926101023
UR  - https://doi.org/10.1017/s1092852926101023
AB  - 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.  Methods: 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.  Results: 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.  Conclusion: These findings support further mechanistic and prospective studies of GLP-1 RAs as a renoprotective strategy for patients receiving lithium treatment.
SN  - 1092-8529
SN  - 2165-6509
ER  -