Glucagon-like-peptide-1 Receptor Agonists in Patients Receiving Maintenance Dialysis (GUARD-1)

Diabetes is the leading cause of kidney failure in Canada. A class of medications called glucagon-like peptide-1 receptor agonists (GLP-1-RA) has been developed for the treatment of diabetes. These medications improve blood sugar control, reduce blood pressure, and promote weight loss. Most importantly, large studies have shown that these medications can also prevent people with diabetes from dying from cardiovascular disease. Cardiovascular disease is the most common cause of death in people receiving long-term dialysis. Despite this, GLP-1-RA have not been well studied in people living with advanced kidney disease. Therefore, it is currently unknown whether people receiving dialysis will benefit from this medication. In addition, the safety profile of these medications in patients with advanced chronic kidney disease is unclear. This pilot randomized controlled trial will randomize diabetic patients receiving dialysis to receive a glucagon-like peptide-1 receptor agonist or placebo. Patients will be followed for 6 months. This study will be a crucial step in determining whether a larger scale trial, designed to evaluate clinically relevant outcomes, will be feasible.