GLP-1 Receptor Agonists, SGLT-2is Slow Renal Function Decline in T2D With Albuminuria

THURSDAY, Oct. 1, 2026 (HealthDay News) — For adults with type 2 diabetes and moderate cardiovascular risk with albuminuria, glucagon-like peptide-1 (GLP-1) receptor agonists or sodium-glucose cotransporter-2 (SGLT-2) inhibitors reduce the risk for deterioration of renal function compared with dipeptidyl peptidase-4 (DPP-4) inhibitors, according to a study published online Sept. 16 in The BMJ.

Alexander Turchin, M.D., from Brigham and Women”s Hospital in Boston, and colleagues conducted a target trial emulation to compare the risk for renal deterioration under treatment with GLP-1 receptor agonists or SGLT-2 inhibitors versus other second-line treatments in adults with type 2 diabetes with and without albuminuria. Participants included 75,455 eligible adults with type 2 diabetes and moderate cardiovascular risk and an estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m² on metformin monotherapy, who were followed for a median of 32 months. The main outcome measure was deterioration of kidney function (defined as doubling of serum creatinine or eGFR <15 mL/min/1.73 m²).

The researchers found that among those without albuminuria (61,583 people), the estimated five-year risk for the renal outcome was 2.4 versus 2.1 percent for people taking GLP-1 receptor agonists or SGLT-2 inhibitors versus those taking DPP-4 inhibitors, and the estimated five-year risk was 3.2 versus 5.4 percent, respectively, among people with albuminuria. Comparing the GLP-1 receptor agonist or SGLT-2 inhibitor group with the DPP-4 inhibitor group yielded an estimated five-year risk ratio of 1.10 (95 percent confidence interval [CI], 0.90 to 1.38) and 0.60 (95 percent CI, 0.42 to 0.82) for those without and with albuminuria, respectively.

“These results underscore the importance of considering albuminuria when making treatment decisions for people with type 2 diabetes at risk of declining renal function,” the authors write.

One author disclosed ties to the pharmaceutical industry.

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