Clinical kidney journalNov 25, 2024

GLP-1 receptor drugs in people with chronic kidney disease who are overweight or obese

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jan 20, 2026

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are approved treatments for improving metabolic control in patients with type 2 diabetes and obesity.

Liraglutide, semaglutide, and tirzepatide are approved for weight management in individuals with obesity (BMI ≥30 kg/m) or overweight (BMI ≥27 kg/m) with related health issues.
Liraglutide and semaglutide can reduce cardiovascular disease (CVD) risk in patients with both CVD and type 2 diabetes.
Semaglutide demonstrated kidney and cardiovascular protection in patients with type 2 diabetes and in clinical trials.
Nephrologists may consider prescribing GLP-1 RAs for patients with overweight and related conditions, obesity, or type 2 diabetes to improve health outcomes.
The review evaluates the safety and effects of GLP-1 RAs on weight, metabolic control, blood pressure, and kidney and cardiovascular outcomes.

Simplified

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as game-changers across the cardiovascular-kidney-metabolic (CKM) spectrum: overweight/obesity, (T2DM) and associated (CKD) and cardiovascular disease (CVD). Liraglutide, semaglutide and tirzepatide are European Medicines Agency approved to improve metabolic control in T2DM and to decrease weight in persons with obesity [body mass index (BMI) ≥30 kg/m] or with overweight (BMI ≥27 kg/m) associated with weight-related comorbidities such as hypertension, dyslipidaemia, CVD and others. Additionally, liraglutide and semaglutide are approved to reduce CVD risk in patients with CVD and T2DM. Semaglutide is also approved to reduce CVD risk in patients with CVD and either obesity or overweight and in phase 3 clinical trials showed kidney and cardiovascular protection in patients with T2DM and albuminuric CKD (FLOW trial) as well as in persons without diabetes that had CVD and overweight/obesity (SELECT trial). Thus, nephrologists should consider prescribing GLP-1 RAs to improve metabolic control, reduce CVD risk or improve kidney outcomes in three scenarios: patients with overweight and a related comorbid condition such as hypertension, dyslipidaemia or CVD, patients with obesity and patients with T2DM. This review addresses the promising landscape of GLP-1 RAs to treat persons with overweight or obesity, with or without T2DM, within the context of CKD, assessing their safety and impact on weight, metabolic control, blood pressure and kidney and cardiovascular outcomes, as part of a holistic patient-centred approach to preserve CKM health. 2 2

Key numbers

24%

Risk Reduction in Progression

Relative risk reduction in cardiovascular or kidney death or progression for semaglutide in FLOW trial.

88%

Participants with Overweight/Obesity

Percentage of FLOW trial participants with overweight/obesity.

Full Text

We can’t show the full text here under this license.

View Full Text ↗

Funding

Competing interests

A.O. is one of the former Editors-in-Chief of CKJ and has received grants from Sanofi and consultancy or speaker fees or travel support from Adviccene, Alexion, Astellas, AstraZeneca, Amicus, Amgen, Boehringer Ingelheim, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Menarini, Mundipharma, Kyowa Kirin, Lilly, Freeline, Idorsia, Chiesi, Otsuka, Novo Nordisk, Sysmex, Vifor Fresenius Medical Care Renal Pharma and Spafarma and is Director of the Catedra UAM-AstraZeneca of chronic kidney disease and electrolytes. He has stock in Telara Farma. B.F.F. has received grants from Esteve and AstraZeneca and consultancy or speaker fees or travel support from AstraZeneca, Bayer, Menarini, Novo Nordisk, Boehringer Ingelheim, Amgen, Mundipharma and Lilly and is Editor for Nefroplus.

PubMed

GLP-1 receptor drugs in people with chronic kidney disease who are overweight or obese

Abstract

Key numbers

Full Text

Funding

Competing interests

You found one interesting study. We’ll send the next 7.

What Lands in Your Inbox Each Week:

Recent issues from the glp-1 therapies brief

Abstract

Key numbers

Full Text

Funding

Competing interests

Related papers

You found one interesting study. We’ll send the next 7.

What Lands in Your Inbox Each Week:

Recent issues from the glp-1 therapies brief