#3754 GLUCAGON-LIKE PEPTIDE TYPE 1 (AGLP1) AGONISTS AND THEIR INITIATION IN KIDNEY TRANSPLANTATION

Abstract Background and Aims Glucagon-like peptide type 1 agonists (aGLP1) is an important therapy to consider for patients with type 2 diabetes (DM2), especially those with chronic disease with glomerular filtration rates (GFR) up to 15ml/min. They stimulate the production and secretion of insulin from pancreatic β cells, delay gastric emptying, promote weight loss, reduce appetite by acting on the central nervous system, and decrease glucagon secretion from pancreatic α cells. OUTCOMES To assess the serum, urinary and clinical effects of treatment with aGLP1 in kidney transplant (KT) patients. Method This is a retrospective observational study of 32 KT patients from our center who met criteria for treatment with aGLP1. In the sample, serum and urinary data are compared, six months before, after and at the time of intervention. The management of DM was evaluated with glycosylated hemoglobin (HbA1C) and basal glycemia levels, before and after the start of treatment. Changes in cardiovascular risk are studied with the number of heart failure episodes, hospital admissions, and changes in the left ventricular ejection fraction. In addition, other parameters such as: hemoglobin (Hb), iron, ferritin, calcium, phosphorus, magnesium, potassium, uric acid, proteinuria and clinical data such as body weight were assessed. Results The sample presented a mean GFR by CKD EPI of 43.2ml/min. A significant drop in body weight was observed, from 93.3kg to 89.2kg (p = 0.001). Regarding the control of DM, no statistically significant results were obtained, a decrease in glycemia figures from 136 to 133 g/dl and HbA1C was obtained, with a reduction of 2.7%, p = 0.404 and p = 0.105, respectively. Regarding the progression of kidney disease, a decrease in proteinuria from 0.33g/day to 0.25 g/day was obtained, as well as a 9.5% protein/creatinine ratio, p = 0.480 and p = 0.721, respectively. Serum creatinine levels unchanged, with a mean of 1.6 mg/dl. Conclusion The aGLP-1 are a valuable treatment option for initiation in KT patients with DM2, having significant efficacy in weight loss. More studies with large samples are required to assess its safety in this population highly affected by DM2 and with borderline GFR.