Therapeutic advances in endocrinology and metabolismJul 25, 2022

The possible benefits of GLP-1 receptor drugs for type 2 diabetes and long-term kidney disease: from clinical trials to everyday treatment

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

Updated Mar 4, 2026

Abstract

affects around 10% of the global population.

Diabetes is the most common cause of chronic kidney disease, leading to a condition known as .
Diabetic kidney disease is progressive and can result in kidney failure, significantly increasing morbidity and mortality.
Current treatments include disease-targeting therapies and indirect therapies addressing related conditions such as hyperglycaemia and hypertension.
Accumulating evidence suggests a potential kidney-protective effect of glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes and chronic kidney disease.
Certain glucagon-like peptide-1 receptor agonists are approved for improving glycaemia and managing weight in people with type 2 diabetes.

Simplified

(CKD) affects around 10% of the global population and is most often caused by diabetes. Diabetes with CKD (, DKD) is a progressive condition that may cause kidney failure and which contributes significantly to the excess morbidity and mortality in these patients. DKD is treated with direct disease-targeting therapies like blockers of the renin-angiotensin system, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and non-steroidal mineralocorticoid receptor antagonists as well as indirect therapies impacting hyperglycaemia, dyslipidaemia, obesity and hypertension, which all together reduce disease progression. While no glucagon-like peptide-1 (GLP-1) receptor agonists () are currently indicated to improve kidney outcomes, accumulating evidence from cardiovascular outcomes trials (CVOTs) corroborates a kidney-protective effect in people with T2D and CKD, and GLP-1 RAs are now mentioned in international treatment guidelines for type 2 diabetes (T2D) with CKD. GLP-1 RAs are indicated to improve glycaemia in people with T2D; certain GLP-1 RAs are also approved for weight management and to reduce cardiovascular risk in T2D. Ongoing pivotal trials are assessing additional indications, including T2D with CKD. In this article, we review and discuss kidney outcomes from a multitude of completed clinical trials as well as real-world evidence and ongoing clinical trials.

Key numbers

32%

Relative Risk Reduction for Kidney Outcomes

Relative risk reduction for composite kidney outcome including macroalbuminuria.

44%

Risk Reduction for Sustained Progression

Risk reduction for sustained eGFR decline assessed over two years.

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Funding

Competing interests

Competing interests: PR has received research support and personal fees from AstraZeneca and Novo Nordisk, and personal fees from Eli Lilly and Company, Boehringer Ingelheim, Astellas Pharma Inc., Gilead, Merck, Merck Sharp and Dohme, Mundipharma, Sanofi and Vifor Pharma. All fees are given to Steno Diabetes Center Copenhagen.

PubMed

The possible benefits of GLP-1 receptor drugs for type 2 diabetes and long-term kidney disease: from clinical trials to everyday treatment

Abstract

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Funding

Competing interests

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

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