Patients were followed from day 90 after PD start, and patient time was assigned to GLP-1 RA use or control based on prescription data. Marginal structural models estimated the average treatment effect in the overlap population, using stabilized inverse probability weights to account for time-varying treatment assignment and censoring.¹

The primary outcome of interest was relative weight change. Secondary outcomes included hospitalization, body surface area (BSA) indexed ultrafiltration and urine output, while HbA1c and mortality were exploratory.¹

GLP-1 RA Exposure, Weight Change and Hospitalization Results

Increasing cumulative GLP-1 RA exposure was associated with progressive weight reduction (−1.19 percentage points [pp]; 95% CI, −1.97 to −0.42; P = .003), with a dose response of −0.73 pp per exposure quarter (P < .001). The association strengthened when the analysis was restricted to new users (−1.69 pp; P < .001).¹

Greater cumulative exposure was also associated with a lower modeled hospitalization burden (incidence rate ratio, 0.935 per exposure quarter; P = .004). BSA indexed ultrafiltration and urine output showed no significant associations.¹

Mortality estimates were directionally protective but imprecise (HR, 0.706; P = .33). HbA1c analyses violated parallel trend assumptions and were interpreted descriptively because of confounding by indication.¹

Brunelli emphasized that the observational design means the findings should inform, rather than settle, clinical decisions, and said he hopes the work builds momentum for a dedicated trial in PD.

“It’s still an observational study. It’s not the same as a clinical trial,” Brunelli said. “In the meantime, for patients who otherwise would be good GLP-1 candidates, our data are consistent with the idea that we shouldn’t deny the patients the GLP-1 specifically because they’re on peritoneal dialysis.”

Editor’s Note: Disclosures for Brunelli include DaVita, Inc.

ReferencesLuo J, Sibbel S, Weinhandl ED, et al. GLP-1 receptor agonist exposure and longitudinal outcomes in patients with type 2 diabetes initiating peritoneal dialysis. Abstract presented at: American Society of Nephrology Kidney Week 2026; October 21-25, 2026; Denver, Colorado. Poster FR-PO1115. doi:10.1681/ASN.202657kx8n1hPerkovic V, Tuttle KR, Rossing P, et al. Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes. N Engl J Med. 2024;391(2):109-121. doi:10.1056/NEJMoa2403347