How previous diabetes treatments affect kidney and heart results of combined SGLT2 inhibitor and GLP-1 receptor agonist therapy in type 2 diabetes with chronic kidney disease

In a study of 438 patients with chronic kidney disease and type 2 diabetes, the incidence of renal composite outcomes was 10% for those receiving GLP-1 receptor agonist first and 17% for those receiving SGLT2 inhibitor first.

• The composite renal outcome included progression to macroalbuminuria and/or a ≥50% decrease in estimated glomerular filtration rate.
• No significant difference in the incidence of renal outcomes was found between the GLP-1RA-first group and the SGLT2 inhibitor-first group.
• The odds ratio for the incidence of renal outcomes was 1.80, suggesting a higher occurrence in the SGLT2 inhibitor-first group, but this was not statistically significant.
• The win ratio indicated a significant advantage for the GLP-1RA-first group, with a win ratio of 1.83, highlighting more favorable renal outcomes.
• These findings may suggest that initiating therapy with GLP-1RA could be associated with better renal outcomes when combined with SGLT2 inhibitors.

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