A large-scale, longitudinal study from DaVita Clinical Research presented at ASN Kidney Week bridges a vital clinical trial gap, examining GLP-1 use and clinical outcomes in home dialysis.
Key Takeaways
Closing a critical evidence gap: While major clinical trials have previously excluded individuals requiring dialysis, this study of 5,900 DaVita patients provides real-world data supporting GLP-1 use in patients on peritoneal dialysis.
Meaningful clinical benefits: Continued GLP-1 therapy drove steady weight reduction and cut hospitalization risk by roughly 6.5% per quarter over a two-year period.
Protected dialysis function: Benefits were achieved without compromising fluid removal (ultrafiltration) or remaining natural kidney function.
Nephrologists managing patients with type 2 diabetes on peritoneal dialysis (PD) face a persistent metabolic dilemma: Thus far, landmark trials for GLP-1 therapies have largely excluded dialysis patients.
New real-world evidence from DaVita Clinical Research (DCR) presented at ASN Kidney Week 2026 bridges this critical gap.
The findings show that cumulative GLP-1 medication use is linked to steady weight loss and fewer hospitalizations among incident PD patients — without compromising fluid removal or remaining kidney function.
What the study found
Patients taking GLP-1 medications experienced steady, meaningful weight loss over time. The longer patients stayed on therapy, the more weight they lost — averaging an additional 0.7% drop in body weight for every three months of treatment. For patients newly prescribed a GLP-1 after starting peritoneal dialysis, this benefit was even stronger, leading to an average weight reduction of 1.7%.
Beyond weight management, the study highlighted key clinical benefits:
- Fewer hospitalizations: Patients on GLP-1 therapies saw their risk of hospital admissions decline by roughly 6.5% for every three months of continued treatment.
- Protected dialysis performance: No significant changes were seen in fluid removal (ultrafiltration) or remaining natural urine output in those on a GLP-1— reassuring proof that dialysis remained effective.
View the complete research poster for more detail.
Research in practice: Safe metabolic control without compromising peritoneal dialysis
While nephrologists often face the challenge of treating patients with complex medical needs, including a high likelihood of metabolic disease, hesitancy around prescribing newer therapies in ESKD often stems from the absence of dedicated trial data in dialysis populations.
Study at a Glance
Population: 5,897 adults with type 2 diabetes starting peritoneal dialysis
Timeframe: April 2021–September 2024 (tracked starting 90 days after PD initiation)
Treatment group: 516 patients (8.7%) prescribed a GLP-1 receptor agonist
Study type: Retrospective longitudinal cohort study using advanced causal modeling
Primary endpoints: Body weight change, and hospitalization risk.
This DaVita study provides clinicians with practical, real-world reassurance that GLP-1 therapy can help manage body weight and curb acute hospitalizations without compromising key performance metrics.
Nephrologists considering GLP-1 therapy for incident PD patients can leverage these findings to support comprehensive diabetes management strategies, pairing lifestyle and home modality support with evidence-based pharmacotherapy.
“Randomized clinical trials have revolutionized diabetes and CKD care, but patients on dialysis are frequently left in an evidence vacuum,” says Steven Brunelli, MD, group vice president of research at DaVita. Brunelli is an author and investigator on the study. “By applying advanced causal inference and marginal structural models to one of the nation’s largest peritoneal dialysis cohorts, we are working to answer the pragmatic questions nephrologists face at the bedside. These findings illustrate how real-world evidence helps clinicians make confident, data-backed decisions that support holistic health and improve day-to-day outcomes for home dialysis patients.”
Learn more about DaVita’s research on GLP-1 therapies for people with ESKD: Glucagon-Like Peptide-1 Receptor Agonist Use and Risks of Hospitalization and Mortality in Patients with ESKD| Clinical Journal of the American Society of Nephrology