GLP1R and stage 5 chronic kidney disease: However, the U.S. Food Drug Administration (FDA) label for GLP-1 RA exenatide states that the drug “should not be used in patients with severe renal impairment or end-stage renal disease and should be used with caution in patients with renal transplantations” [12], and the FDA’s label for lixisenatide recommends monitoring of renal function when initiating or escalating doses of the drug and states that the drug “is not recommended in patients with end stage renal disease” [13].