Glucagon-like Peptide-1 Receptor Agonists in Kidney Transplant Recipients – A Retrospective Single Center Study

Joana Freitas; José Silvano; Catarina Ribeiro; Jorge Malheiro; Sofia  Pedroso; Manuela Almeida; Isabel Fonseca; La Salete Martins

Autores

Joana Freitas Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0001-5343-6797
José Silvano Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0002-5266-2300
Catarina Ribeiro Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0001-6813-0336
Jorge Malheiro Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0002-9625-5889
Sofia Pedroso Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0002-8539-906X
Manuela Almeida Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0002-1683-1314
Isabel Fonseca Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0001-8984-1751
La Salete Martins Centro Hospitalar Universitário de Santo António – Porto – Portugal. https://orcid.org/0000-0002-6110-2102

Palavras-chave:

Agonistas do Receptor de Peptídeo Semelhante ao Glucagon-1, Transplante Renal, Diabetes Mellitus

Resumo

Objetivos: A incidência de diabetes pós-transplante e o aumento do risco cardiovascular entre os receptores de transplante estão em ascensão. Os agonistas do receptor de peptídeo semelhante ao glucagon têm o potencial de mitigar os efeitos dos medicamentos imunossupressores, abordando tanto a hiperglicemia quanto o aumento de peso, o que os torna atrativos para uso nesta população, dadas as suas vantagens cardiovasculares e renoprotetoras. No entanto, a evidência atual é insuficiente sobre a sua eficácia em receptores de transplante renal diabéticos (RTRD). Métodos: O objetivo deste estudo retrospectivo foi avaliar a eficácia e segurança dos agonistas do peptídeo semelhante ao glucagon-1 em RTRD. O foco principal foi avaliar o seu impacto em vários parâmetros, tais como níveis de hemoglobina A1c, índice de massa corporal (IMC), perfil lipídico, níveis de hemoglobina, função do enxerto renal (taxa de filtração glomerular estimada [TFGe]) e relação proteína-creatinina urinária. Resultados: Durante um período de observação mediano de 18 meses, esta investigação incluiu 64 pacientes transplantados renais. A TFGe mediana no início foi de 61,9 mL/min/1,73 m² e permaneceu estável durante o acompanhamento. A mediana da HbA1c diminuiu de 7,5 para 7% (IC95%; p < 0,002). Também foi observada uma melhoria significativa no IMC e no perfil lipídico. Não foram observadas mudanças significativas nos níveis medianos de creatinina e relação proteína:creatinina urinária. Nenhum efeito colateral justificou a descontinuação do medicamento. Conclusão: Este estudo mostra que o uso de agonistas do peptídeo semelhante ao glucagon é viável e bem tolerado em RTRD, sem efeitos colaterais significativos observados. Estudos subsequentes são necessários para explorar se esta terapêutica pode melhorar efetivamente a sobrevida do aloenxerto nesses pacientes.

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