GLP-1RAs Use and Postoperative Outcomes in T2DM Patients Undergoing Radical Nephrectomy.

INTRODUCTION: To determine the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and postoperative outcomes, including 90-day complications and overall survival, in patients with type 2 diabetes mellitus (T2DM) undergoing radical nephrectomy (RN) for renal cell carcinoma (RCC). PATIENTS AND METHODS: This retrospective study was conducted using the TriNetX database. The cohort of T2DM patients who underwent RN and were prescribed GLP-1RAs was identified and matched 1:1 with non-GLP-1RA controls based on demographics, comorbidities, metformin and insulin prescription, and renal function laboratory values. Risk difference, risk ratio, and odds ratio with 95% confidence intervals were measured for 90-day postoperative complications. Kaplan-Meier analysis, log-rank tests, and multivariable Cox proportional hazards models evaluated the association of GLP-1RA use with overall survival. RESULTS: GLP-1RAs use was associated with decreased odds of arrhythmia (odds ratio [OR] = 0.766) and ileus (OR = 0.405) compared to the non-GLP-1RAs group (P < .05 for each). No significant association was observed between GLP-1RAs use and odds of acute kidney injury (P > .05). Kaplan-Meier analysis and log-rank tests showed improved 2-year and 3-year overall survival among patients prescribed GLP-1RAs compared to those who were not (P < .001 for each). CONCLUSION: Our study parallels ongoing studies examining the broader benefits of GLP-1RA use, demonstrating a decreased incidence of 90-day postoperative ileus and arrhythmia, as well as improved overall survival. Prospective studies are warranted to validate these findings.