Kidney Week

Abstract: TH-PO1060

Effects of Glucagon-Like Peptide 1 Agonists (GLP-1 RAs) on Ectopic Fat Deposition in CKD: A Pilot and Feasibility Study (GLIMP)

Session Information

• CKD: Therapeutic Advances
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Dilaver, Ragibe Gulsah, Vanderbilt University Medical Center, Department of Medicine, Nashville, Tennessee, United States

Ragibe Gulsah Dilaver, MD

• Crescenzi, Rachelle, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Rachelle Crescenzi, PhD

• Elsurer Afsar, Rengin, Saint Louis University Department of Internal Medicine, St Louis, Missouri, United States

Rengin Elsurer Afsar, MD

• Gamboa, Jorge, Vanderbilt University Medical Center, Department of Medicine, Nashville, Tennessee, United States

Jorge Gamboa, MD, PhD

• Ikizler, Talat Alp, Vanderbilt University Medical Center, Department of Medicine, Nashville, Tennessee, United States

Talat Alp Ikizler, MD, FASN

Background

Ectopic fat deposition, including intermuscular adipose tissue (IMAT), is associated with metabolic derangements such as insulin resistance (IR) and inflammation in patients with CKD. GLP-1RA reduces ectopic fat deposition in patients with type 2 diabetes and obesity. In a pilot and feasibility study, we aimed to test whether dulaglutide administration decreases IMAT accumulation and improves physical performance in patients with stage 3-4 CKD.

Methods

We prospectively enrolled 7 patients with stage 3-4 CKD serving as their own controls. Dulaglutide (1.5 mg/week) was administered for 12 weeks. IMAT accumulation in the quadriceps muscle using magnetic resonance imaging, biochemical markers including markers of inflammation and insulin resistance, and physical performance were measured before and after administration.

Results

Participant demographics were as follows: age 59 ± 8 years, BMI 31.4 ± 4.1 kg/m2, 57.1% female, and baseline eGFR 31.7 ± 9.0 mL/min/1.73m2. Two patients had type 2 diabetes. IMAT accumulation was 0.104 ± 0.041 before treatment and 0.095 ± 0.033 after treatment (p = 0.69), (Figure 1). BMI levels were significantly lower after the treatment (p < 0.001). There were no statistically significant differences in HbA1c, Hs-CRP, total cholesterol, triglyceride concentrations, short physical performance battery test scores before and after treatment (Table 1). Medication was well tolerated except one participant stopped early due to nausea and one due to injection site drug reaction.

Conclusion

In this pilot and feasibility study in patients with stage 3-4 CKD, 12 weeks of dulaglutide administration decreased IMAT accumulation numerically but the difference did not reach statistical significance. The medication was well tolerated. Larger studies are needed to examine the metabolic effects GLP-1RAs in patients with CKD.

Funding

• NIDDK Support