---
title: "GLP‑1 Receptor Agonists and Reduced Sepsis Risk in CKD with Type 2 Diabetes"
id: "pubmed-42566276"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42566276"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42566276/"
doi: "10.1093/ndt/gfag175"
published_at: "2026-08-07T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# GLP‑1 Receptor Agonists and Reduced Sepsis Risk in CKD with Type 2 Diabetes
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42566276
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42566276/)
- **DOI:** [10.1093/ndt/gfag175](https://doi.org/10.1093%2Fndt%2Fgfag175)
- **Published At:** 2026-08-07T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Background: Chronic kidney disease (CKD) increases sepsis risk and worsens infectious outcomes. The potential protective effects of **GLP‑1 receptor agonists (GLP‑1RA)** on infection in CKD patients with type 2 diabetes were unknown. - Study design: Retrospective cohort analysis using the **TriNetX** electronic health-record network of adults with CKD and type 2 diabetes who initiated GLP‑1RA or **DPP‑4 inhibitors (DPP‑4i)** between January 2020 and May 2026. - Cohorts: After propensity score matching, the analysis included 21,035 patients in each treatment arm (GLP‑1RA vs DPP‑4i). - Primary outcome: Incident **sepsis**. Secondary outcomes: all‑cause mortality, septic shock, pneumonia, urinary tract infection (UTI), and COVID‑19. - Main findings: GLP‑1RA use was associated with a lower risk of sepsis compared with DPP‑4i (hazard ratio [HR] 0.72; 95% CI 0.66–0.78). - Secondary outcomes: GLP‑1RA was also associated with lower risks of **all‑cause mortality** (HR 0.65; 95% CI 0.61–0.70), pneumonia (HR 0.81; 95% CI 0.75–0.87), UTI (HR 0.83; 95% CI 0.79–0.88), and COVID‑19 (HR 0.84; 95% CI 0.77–0.90). - Septic shock: Numerically lower with GLP‑1RA (HR 0.84; 95% CI 0.73–0.96; P = 0.014) but did not meet the Bonferroni‑corrected significance threshold as reported. - Conclusion: In this matched retrospective cohort, initiation of **GLP‑1RA** versus **DPP‑4i** in adults with CKD and type 2 diabetes was associated with lower risks of sepsis, mortality, and several infectious outcomes. - Data and reporting limits: The source is the article abstract; details on variable definitions, matching covariates, absolute event rates, follow‑up duration, and sensitivity analyses were not reported in the abstract. - Citation: Yu‑Yang Tseng et al., Nephrol Dial Transplant (online ahead of print, 2026).
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Online ahead of print. # Sepsis and Infectious Outcomes for GLP-r Agonists in CKD plus Type 2 Diabetes [Yu-Yang Tseng](https://pubmed.ncbi.nlm.nih.gov/?term=Tseng+YY&cauthor_id=42566276)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-1 "Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan."), [Hsien-Yi Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+HY&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-3 "Department of Sport Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Jui-Yi Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+JY&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-4 "Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Ming-Yan Jiang](https://pubmed.ncbi.nlm.nih.gov/?term=Jiang+MY&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-5 "Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Chih-Cheng Lai](https://pubmed.ncbi.nlm.nih.gov/?term=Lai+CC&cauthor_id=42566276)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-6 "Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-7 "School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan."), [Min-Hsiang Chuang](https://pubmed.ncbi.nlm.nih.gov/?term=Chuang+MH&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#full-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.") Affiliations Expand ### Affiliations * 1 Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan. * 2 Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan. * 3 Department of Sport Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 4 Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 5 Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 6 Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan. * 7 School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan. * PMID: **42566276** * DOI: [ 10.1093/ndt/gfag175 ](https://doi.org/10.1093/ndt/gfag175) Item in Clipboard # Sepsis and Infectious Outcomes for GLP-r Agonists in CKD plus Type 2 Diabetes Yu-Yang Tseng et al. Nephrol Dial Transplant. 2026. Show details Display options Display options Format Abstract PubMed PMID Nephrol Dial Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Nephrol+Dial+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Nephrol+Dial+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42566276/) . 2026 Aug 7:gfag175. doi: 10.1093/ndt/gfag175. Online ahead of print. ### Authors [Yu-Yang Tseng](https://pubmed.ncbi.nlm.nih.gov/?term=Tseng+YY&cauthor_id=42566276)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-1 "Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan."), [Hsien-Yi Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+HY&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-3 "Department of Sport Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Jui-Yi Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+JY&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-4 "Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Ming-Yan Jiang](https://pubmed.ncbi.nlm.nih.gov/?term=Jiang+MY&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-5 "Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."), [Chih-Cheng Lai](https://pubmed.ncbi.nlm.nih.gov/?term=Lai+CC&cauthor_id=42566276)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-6 "Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-7 "School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan."), [Min-Hsiang Chuang](https://pubmed.ncbi.nlm.nih.gov/?term=Chuang+MH&cauthor_id=42566276)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42566276/#short-view-affiliation-2 "Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.") ### Affiliations * 1 Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan. * 2 Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan. * 3 Department of Sport Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 4 Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 5 Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. * 6 Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan. * 7 School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan. * PMID: **42566276** * DOI: [ 10.1093/ndt/gfag175 ](https://doi.org/10.1093/ndt/gfag175) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Chronic kidney disease (CKD) is associated with a higher risk of sepsis and poorer clinical outcomes compared to the general population. While GLP-1 receptor agonists (GLP-1RA) may confer protective effects against sepsis beyond their metabolic benefits in patients with diabetes, their effect in CKD patients remains unclear. This study aims to evaluate the association between GLP-1RA therapy and infectious outcomes in patients with CKD. **Methods:** Using the TriNetX database, we conducted a retrospective cohort study of adults with CKD and type 2 diabetes mellitus initiating GLP-1RAs or dipeptidyl peptidase-4 inhibitors (DPP-4i) between January 2020 and May 2026. The primary outcome was sepsis. Secondary outcomes included all-cause mortality, septic shock, pneumonia, urinary tract infection, and COVID-19. **Results:** After propensity score matching, 21 035 patients were included in each treatment group. Use of GLP-1RA was associated with a lower risk of sepsis compared with DPP-4i (HR = 0.72; 95% CI, 0.66-0.78). GLP-1RA use was also associated with lower risks of all-cause mortality (HR = 0.65; 95% CI, 0.61-0.70), pneumonia (HR = 0.81; 95% CI, 0.75-0.87), urinary tract infection (HR = 0.83; 95% CI, 0.79-0.88), and COVID-19 (HR = 0.84; 95% CI, 0.77-0.90). The risk of septic shock did not reach Bonferroni-corrected significance level despite being numerically lower (HR = 0.84; 95% CI, 0.73-0.96; P = 0.014). **Conclusions:** In patients with CKD and type 2 diabetes mellitus, use of GLP-1RA is associated with lower risks of sepsis, all-cause mortality, pneumonia, urinary tract infection, and COVID-19 compared with DPP-4i, while the risk of septic shock was similar between groups. **Keywords:** chronic kidney disease; glucagon-like peptide-1 receptor agonists; sepsis; type 2 diabetes mellitus. © The Author(s) 2026. Published by Oxford University Press on behalf of the ERA. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. 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