{"id":"41641cf20e57","type":"article","url":"https://hartvaat.nl/2026/10/20/peg-loxenatide-vermindert-niercomplicaties-bij-diabetespatienten-met-chronische-/","title":"PEG-loxenatide vermindert niercomplicaties bij diabetespatiënten met chronische nierziekte — multicenter cohortstudie","title_en":"Real-world renoprotective effects of polyethylene glycol-loxenatide in type 2 diabetes: a multicenter, ambispective cohort study.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Signal transduction and targeted therapy","doi":"10.1038/s41392-026-02945-5","source_url":"https://doi.org/10.1038/s41392-026-02945-5","authors":["Junjun Ye","Jilin Li","Yongsong Chen","Fengwu Chen","Dan Zhu","Chuangyan Zhang","Qianyi Chen","Yu Tian","Shuhui Yang","Wencan Xu","Bin Xie","Zhe-Sheng Chen","Kaijian Hou"],"significance":6,"published":"2026-10-29","source_date":"2026-10-20","image":"https://hartvaat.nl/global/img/dee5fdc32ac1.webp","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"In a multicenter ambispective cohort of 3,305 patients with type 2 diabetes and chronic kidney disease, polyethylene glycol-loxenatide demonstrated significant renoprotective effects compared to non-incretin-based standard care. After a median follow-up of 36.4 months, the drug was associated with a substantially lower risk of a composite kidney outcome (HR 0.44 in the propensity-matched cohort), with benefits increasing at 6- and 12-month landmark analyses. While an initial reduction in 3-point MACE was observed in the unmatched cohort, this effect disappeared after matching, rendering cardiovascular findings exploratory. These real-world data support the renal benefits of PEG-loxenatide in high-risk cardiometabolic patients, though randomized trials are needed to confirm cardiovascular outcomes.","created":"2026-10-22T01:18:39Z","updated":"2026-10-22T01:18:41Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een multicenter cohortstudie van 3305 patiënten met type 2-diabetes en chronische nierziekte werd het renoprotectieve effect van PEG-loxenatide vergeleken met niet-incretine-gebaseerde standaardzorg. Na een mediaan follow-up van 36,4 maanden was het middel geassocieerd met een significant lager risico op een samengestelde nieruitkomst (HR 0,44 bij propensity score-matching), met een progressief voordeel op 6 en 12 maanden. Hoewel in de ongematchte analyse een reductie in 3-punts MACE werd gezien, verdween dit effect na matching, wat de cardiovasculaire bevindingen exploratoir maakt. Deze real-world data ondersteunen het nierbeschermende potentieel van PEG-loxenatide bij hoogrisicopatiënten, hoewel gerandomiseerde trials cardiovasculaire uitkomsten moeten bevestigen.","abstract_original":"Patients with type 2 diabetes mellitus and chronic kidney disease face persistent risks despite standard care. Polyethylene glycol-loxenatide lacks real-world renoprotective evidence in high-risk Chinese populations relative to non-incretin-based standard care. This multicenter, ambispective cohort study enrolled 3305 patients with type 2 diabetes mellitus, renal impairment, and elevated cardiovascular risk at six Chinese tertiary institutions (median follow-up 36.4 months; trial registration: ChiCTR2300073001). Data were extracted via an artificial intelligence-enhanced pipeline. Co-primary analyzes comprised multivariable-adjusted Cox regression and 1:1 propensity score matching (332 per group); pre-specified landmark analyzes at 6 and 12 months addressed immortal time bias. Polyethylene glycol-loxenatide was associated with a reduced risk of the primary kidney composite outcome in the original cohort (hazard ratio [HR], 0.49; 95% CI, 0.25-0.95; P = 0.035), which was corroborated in the propensity score matched cohort (HR, 0.44; 95% CI, 0.20-0.97; P = 0.043) and progressive across 6-month (HR, 0.40; 95% CI, 0.19-0.84) and 12-month (HR, 0.33; 95% CI, 0.14-0.75) landmarks. While a reduction in 3-point major adverse cardiovascular events was observed in the unmatched cohort (HR, 0.60; 95% CI, 0.43-0.85; P = 0.004), this association was not sustained in the matched analysis (HR, 0.92; 95% CI, 0.57-1.48; P = 0.735). In conclusion, long-term therapy was associated with an attenuated risk of major renal events. Given the null findings in the matched cohort, the cardiovascular observations are exploratory and require randomized confirmation."}