Current opinion in nephrology and hypertensionMay 4, 2026

Remission in diabetic kidney disease: what we know and what’s next

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated May 5, 2026

Abstract

Recent trials show sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists could significantly slow eGFR decline and reduce albuminuria in diabetic kidney disease.

Diabetic kidney disease is associated with a progressive decline in kidney function and increased cardiovascular risks.
Novel pharmacologic therapies have demonstrated the potential to improve both kidney and cardiovascular outcomes.
Some patients may experience disease remission, characterized by improved eGFR and reduced albuminuria, with appropriate treatment.
There is currently a lack of standardized definitions and long-term outcome data regarding disease remission in diabetic kidney disease.

Simplified

PURPOSE OF REVIEW: Diabetes is the leading cause of chronic kidney disease (CKD) worldwide. Diabetic kidney disease (DKD) has traditionally been viewed as a progressive condition characterized by declining estimated glomerular filtration rate (eGFR) and worsening albuminuria, with affected individuals facing substantially elevated risks of major adverse cardiovascular events and kidney failure. However, recent advances in pharmacologic therapies have demonstrated dramatic improvements in both cardiovascular and kidney outcomes. The objective of this review is to summarize the evidence for contemporary pharmacologic therapies in DKD, and to examine the emerging concept of disease remission in DKD.

RECENT FINDINGS: Randomized controlled trials of sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists have demonstrated significant attenuation of eGFR decline and reductions in albuminuria. These findings have given rise to the hypothesis that, with guideline-directed therapy, some patients with DKD may achieve disease remission, defined by physiologic declines in eGFR and minimal (or resolved) albuminuria. Emerging evidence not only highlights the promise of this paradigm but also underscores the lack of standardized definitions and long-term outcome data.

SUMMARY: Emerging pharmacologic therapies are transforming DKD. Reframing DKD management from one of slowing progression to achieving remission could have important implications for clinical practice worldwide.

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Remission in diabetic kidney disease: what we know and what’s next

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