Diabetes therapy : research, treatment and education of diabetes and related disorders

Kidney effects of GLP-1 receptor drugs and Tirzepatide in different stages of chronic kidney disease and metabolic types (type 2 diabetes and/or overweight)

Updated

Abstract

Out of 607 records identified, 35 studies demonstrated renal benefits for GLP-1-based therapies in adults with type 2 diabetes and/or overweight/obesity.

  • Randomized controlled trials indicate that semaglutide, dulaglutide, and liraglutide may reduce composite kidney outcomes and slow the decline in estimated glomerular filtration rate (eGFR).
  • Tirzepatide is associated with consistent reductions in albuminuria and a slower decline in eGFR compared to insulin glargine.
  • Other agents like efpeglenatide, cotadutide, exenatide, and lixisenatide demonstrate class-consistent effects in reducing protein levels in urine.
  • Observational studies extend these findings to real-world settings and populations with advanced chronic kidney disease (CKD).
  • Renal benefits observed across agents appear to be partly independent of their effects on blood sugar and weight.

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Funding

Competing interests

Declarations. Conflicts of Interest: The authors declare the following conflicts of interest. Rodrigo Daza-Arnedo has received speaker honoraria from Novo Nordisk, AstraZeneca, Bayer, and Boehringer Ingelheim. Alicia Elbert has been a member of the speaker boards of AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Sanofi, Servier, Raffo, Baliarda, and Adium, and has served as an investigator in studies sponsored by Novo Nordisk, Boehringer Ingelheim, AstraZeneca, and Merck. Ricardo Correa-Rotter has served as a member of the Global Research Committee of FLOW and as national lead for the FLOW and TRIUMPH programs. Eliana Dina-Batlle declares no conflicts of interest. Eduardo Lorca-Herrera has participated in advisory boards for AstraZeneca, Boehringer Ingelheim, Axon Pharma, and Fresenius Medical Care; has received speaker honoraria from AstraZeneca, Boehringer Ingelheim, Novo Nordisk, and Axon Pharma; and has received travel or conference support from AstraZeneca, Boehringer Ingelheim, and Novo Nordisk. Thyago Proença de Moraes has received speaker or consulting fees from AstraZeneca, Bayer, Baxter/Vantive, Boehringer Ingelheim, CSL Vifor, Libbs, Lilly, Merck, Novo Nordisk, Servier, and Takeda. Vicente Sánchez-Poli has received speaker honoraria from Bayer, Boehringer Ingelheim, AstraZeneca, Novo Nordisk, Novartis, and Janssen. Jorge Rico-Fontalvo has received speaker honoraria from AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Lilly, Sanofi, Eurofarma, Adium, GSK, MSD, Merck, and Bayer. He has participated in advisory boards for AstraZeneca, Boehringer Ingelheim, Adium, Lilly, Bayer, and Novo Nordisk. Carlos E. Builes-Montaño has received consulting and speaking fees from Sanofi, Novo Nordisk, Novartis, Recordati Rare Diseases, Janssen, Chiesi, Abbott, and Boehringer Ingelheim, and is a shareholder of Festina Lente. These disclosures are not necessarily related to the submitted work. Ethical Approval: Ethics approval was not required for this review because it is based exclusively on previously conducted, publicly available studies and does not contain any new studies with human participants or animals performed by any of the authors.
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