GLP-1 receptor agonist use and contrast-associated acute kidney injury after contrast-enhanced CT and CT angiography in adults with type 2 diabetes and chronic kidney disease: a propensity score-matched cohort study
- Design
- Retrospective cohort · 20560 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different populationINDIRECT: all participants had type 2 diabetes and chronic kidney disease and were having contrast imaging; age and BMI are not reported.
- Could weight loss explain it?
- PossiblyHbA1c stayed imbalanced between users and non-users after matching, so glycaemic differences were not separated from a drug effect; no weight data are reported.
- Study tier
- Study tier 3LOW: single retrospective TriNetX cohort with propensity matching; the observational design caps the tier.
- Assessment
- Version 4 · Two reviewers differed; settled by a recorded ruling · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
This study used TriNetX health records of adults with type 2 diabetes and chronic kidney disease who had contrast CT scans, comparing people with a GLP-1 receptor agonist prescription in the six months before imaging with matched non-users. Kidney injury within three days was less common in users: 3.8% versus 4.5% after CE-CT (OR 0.84, 95% CI 0.71-0.99) and 4.5% versus 6.1% after CT angiography (OR 0.74, 95% CI 0.59-0.92). Negative-control outcomes were null, results by kidney-function level were inconsistent, and HbA1c stayed imbalanced, so this is an association, not proof of protection.
01Findings
What the study reported
- Drugs
- Glp-1 receptor agonists
- Dose
- various
- Comparator
- non-users
- Primary outcome
- new acute kidney injury diagnosis within three days of contrast-enhanced CT or CT angiography (CA-AKI)
- Effect
- CA-AKI 3.8% in users vs 4.5% in non-users after CE-CT (OR 0.84) and 4.5% vs 6.1% after CTA (OR 0.74); absolute risk differences 0.7% points and 1.5% points; negative-control outcomes null; eGFR-stratified associations inconsistent between cohorts
- 95% confidence interval
- CE-CT: 95% CI 0.71-0.99; CTA: 95% CI 0.59-0.92
- Follow-up
- three days after imaging (outcome window)
- Adverse events
- not reported in abstract
- Limitations
- Retrospective observational design; HbA1c remained imbalanced after matching and eGFR-stratified associations were inconsistent, and the outcome was an AKI diagnosis rather than creatinine-based, so the authors call for prospective studies using creatinine-based outcomes.
Who was studied
- Obesity status
- not reported in abstract
- Diabetes status
- type 2 diabetes required
- Cvd status
- not reported in abstract
- Ckd status
- CKD required (stage not specified)
- Baseline condition
- type 2 diabetes with CKD, undergoing contrast-enhanced CT or CT angiography
- Sample size
- 20560
- Inclusion exclusion
- adults with type 2 diabetes and CKD who underwent CE-CT or CTA from January 2020 to January 2025 (TriNetX)
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 20560
- Randomization
- no
- Blinding
- n/a
- Comparator
- non-users
- Follow up duration
- three days after imaging (outcome window)
- Outcome type
- hard
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- INDIRECT
- Statistical precision
- CIs reported (CE-CT upper bound 0.99); event rates 3.8% vs 4.5% (CE-CT) and 4.5% vs 6.1% (CTA); event counts not stated; 6,995 and 3,285 matched pairs
- Risk of bias
- not assessed
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- not reported in abstract
- Author conflicts
- The authors declare no conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[AIMS] To examine whether glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is associated with contrast-associated acute kidney injury (CA-AKI) after contrast-enhanced computed tomography (CE-CT) or computed tomographic angiography (CTA) in adults with type 2 diabetes and chronic kidney disease (CKD). [METHODS] We conducted a TriNetX retrospective cohort study of adults with type 2 diabetes and CKD who underwent CE-CT or CTA from January 2020 to January 2025. GLP-1 RA use was defined by a prescription within six months before imaging. The primary outcome was a new acute kidney injury diagnosis within three days. Separate 1:1 propensity score-matched analyses were conducted for CE-CT and CTA, with eGFR-stratified and sensitivity analyses. [RESULTS] After matching, the CE-CT and CTA cohorts included 6,995 and 3,285 pairs, respectively. CA-AKI occurred in 3.8% of GLP-1 RA users versus 4.5% of non-users after CE-CT (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.71-0.99) and in 4.5% versus 6.1% after CTA (OR 0.74, 95% CI 0.59-0.92). The absolute risk differences were 0.7% points and 1.5% points, respectively. HbA1c remained imbalanced after matching. Negative-control outcomes were null, and eGFR-stratified associations were inconsistent between cohorts. [CONCLUSIONS] GLP-1 RA use was associated with a lower observed risk of CA-AKI after CE-CT and CTA in adults with type 2 diabetes and CKD. Residual HbA1c imbalance and the observational design limit causal interpretation; prospective studies using creatinine-based outcomes are needed.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Oct 18, 2026 | 42886239 first ingestion |