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

Purpose: 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 [greater than or equal to]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 [greater than or equal to]6 months. Mean duration of tirzepatide use in our cohort was 13.89 [+ or -] 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