Evidence map›Paper›PMID 41232069›Full record

ArticleDiabetes care2026

GLP-1s Versus DPP-4s and Risk of Dementia in Patients Requiring Hemodialysis: A Target Trial Emulation Study.

Dustin Le, Mark Kilpatrick, Walter K Kraft, Morgan E Grams, Bernard G Jaar, Jung-Im Shin

Abstract read
In one paragraph

Article in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dustin LeDivision of Nephrology, Thomas Jefferson University, Philadelphia, PA.ORCID 0000-0003-3231-6758
Mark KilpatrickDepartment of Medicine, Thomas Jefferson University, Philadelphia, PA.
Walter K KraftDepartment of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA.
Morgan E GramsDivision of Precision Medicine, New York University, New York, NY.
Bernard G JaarDivision of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD.
Jung-Im ShinDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Funding

Medication Use and Adverse Events in CKDR01DK115534 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Alexander R Chang, Morgan Erika Grams · 2018 to 2026
$5.7M
Challenges to Guideline-Recommended Diabetes Care in the United StatesR01DK139324 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Jung-Im Shin · 2025 to 2026
$1.4M
National Kidney Foundation Young Investigator AwardNIDDK NIH HHS R01 DK115534NIDDK NIH HHS R01DK115534NIDDK NIH HHS R01 DK139324NIDDK NIH HHS R01DK139324
6 · The paper itself

Abstract

objectiveGlucagon-like peptide 1 agonists (GLP-1s) compared with dipeptidyl peptidase 4 inhibitors (DPP-4s) are associated with reduced risk of dementia in the general population with diabetes, but whether this association is true for patients requiring hemodialysis is unknown. RESEARCH DESIGN AND

methodsUsing the U.S. Renal Data System and Medicare Parts A, B, and D claims data from 2011 to 2021, we used the active comparator, new-user design to evaluate incident dementia comparing GLP-1s versus DPP-4s among individuals with both diabetes and hemodialysis dependence. We used inverse probability of treatment weights (IPTW) to balance baseline characteristics and Fine-Gray models to estimate subdistribution hazard ratios (sHRs) accounting for competing risks of death and kidney transplantation. We estimated intention-to-treat and as-treated effects.

resultsWe identified 3,619 GLP-1 users and 11,502 DPP-4 users. After IPTW, the average individual was 63 years old, 63% were White, and mean BMI was 31 kg/m2. The median (interquartile interval) follow-up was 1.5 (0.6-2.9) years, and 2,014 patients received a dementia diagnosis. In the intention-to-treat analysis, the IPTW-sHR for dementia was 0.82 (95% CI 0.67-0.98), and after 2 years of follow-up, the cumulative incidence of dementia was 10.2% on GLP-1s vs 11.2% on DPP-4s. As-treated and subgroup analyses were consistent. GLP-1s were also associated with an increased risk of ketoacidosis (sHR 1.52, 95% CI 1.14-2.02; 2-year cumulative incidence: 3.1% vs. 2.2%).

conclusionsIn patients with diabetes requiring hemodialysis, GLP-1s (vs. DPP-4s) may be a promising therapy to reduce the risk of dementia.

Indexed as

DementiaDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide 1Hypoglycemic AgentsRenal DialysisAgedDiabetes Mellitus, Type 2FemaleHumansMaleMiddle AgedDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide 1Hypoglycemic Agents

Identifiers

PMID41232069
PMCPMC12719713

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.