INDISCRIMINATE USE OF TIRZEPATIDE IN AESTHETIC CLINICS: POTENTIAL RENAL COMPLICATIONS IN INDIVIDUALS WITH METABOLIC COMORBIDITIES AND EXCESS BODY WEIGHT

Abstract

The increasing use of tirzepatide in aesthetic contexts has raised concerns regarding clinical safety, particularly concerning the risk of renal complications in individuals with diabetes mellitus and obesity. Tirzepatide is a dual agonist of the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors, which influences glycemic control and body weight reduction. This study aimed to highlight potential renal complications associated with the indiscriminate use of tirzepatide for aesthetic purposes, considering the underlying pathophysiological mechanisms and relevant risk factors. An integrative literature review was conducted—employing a qualitative, descriptive approach—using the PubMed, SciELO, and LILACS databases, with search terms related to tirzepatide, renal function, obesity, diabetes mellitus, and adverse effects. The findings indicate that nausea, vomiting, diarrhea, reduced appetite, and low fluid intake can lead to dehydration, hypovolemia, decreased renal perfusion, and a reduction in the glomerular filtration rate. Furthermore, reports were identified involving fluid and electrolyte imbalances, acid-base disturbances, prerenal kidney injury, acute tubular injury, and tubulointerstitial nephritis. These risks were particularly significant in patients with pre-existing renal disease, the elderly, individuals subjected to inappropriate dose escalation, and those using diuretics, renin-angiotensin-aldosterone system (RAAS) blockers, or SGLT2 inhibitors. It is concluded that while renal complications are rare—documented primarily in case reports—they can be clinically severe. The use of tirzepatide requires appropriate clinical indication, gradual dose titration, and monitoring of renal function, hydration status, and electrolyte levels.