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exenatide is specifically not recommended in patients with end-stage renal disease (it is cleared renally)
It's the reality of the world we live in now
However, when taking a GLP-1 receptor agonist like Ozempic (semaglutide), this reflex can feel significantly more intense
R., Bozorgi, M., & Khazaei, M
Curr DiabRep 20:19 Mantovani A, Petracca G, Beatrice G, Csermely A, Lonardo A, Targher G (2021) Glucagon-like peptide-1 receptor agonists for treatment of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: an updated meta-analysis of randomized controlled trials
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