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Additional class-related concerns include: Gallbladder disease , including cholelithiasis (gallstones) and cholecystitis, as observed with GLP-1 receptor agonist medicines [27] Dehydration and acute kidney injury (AKI) risk secondary to significant gastrointestinal fluid losses Increased heart rate , a recognised class effect of GLP-1 receptor agonists Pancreatitis a potential risk that warrants prompt medical assessment if severe abdominal pain develops Thyroid C-cell tumours observed in rodent studies with GLP-1 receptor agonists