Tirzepatide Prescribing Practices and Efficacy in Patients with Diabetes and Chronic Kidney Disease at a Large Tertiary Care Center in the United States

Sriya Amruta Kosaraju,1 Rong M Zhang2 1Department of Biomedical Sciences, University of Missouri-Kansas City, Kansas City, MO, USA; 2Department of Medicine-Division of Endocrinology, Washington University, St Louis, MO, USACorrespondence: Rong M Zhang, Department of Medicine-Division of Endocrinology, Washington University, 660 South Euclid Avenue, St Louis, MO, 63110, USA, Email [email protected]: Chronic kidney disease is a frequent complication of diabetes mellitus. Tirzepatide is the first dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved for glycemic control in patients with type 2 diabetes. We present the efficacy and prescribing practices of tirzepatide in a cohort with diabetes and chronic kidney disease in a large tertiary care setting.Methods: We retrospectively identified new outpatient tirzepatide prescriptions in adults ≥ 18 years with diabetes and chronic kidney disease stages 1– 5 from 2022 to 2023 across the Barnes Jewish Hospital system (St Louis, Missouri).Results: We identified 102 subjects with chronic kidney disease and diabetes who started tirzepatide between 2022 and 2023, and used for ≥ 6 months. Mean duration of tirzepatide use in our cohort was 13.89 ± 2.51 months. Among subjects who stopped, 57% (n=4) were due to limited medication availability or lack of insurance coverage. Tirzepatide use led to a significant reduction in hemoglobin A1c by 1.15%, weight by nearly 10%, systolic and diastolic blood pressure, and total cholesterol (p< 0.05 for all).Conclusion: We found that tirzepatide was an effective therapy with significant benefits on glycemic control, blood pressure, cholesterol, and weight in subjects with diabetes and chronic kidney disease treated at a tertiary care facility.Keywords: chronic kidney disease, diabetes, tirzepatide, incretin