Kidney Parameters with Tirzepatide in Obesity with or without Type 2 Diabetes
Hiddo J L Heerspink1, Allon N Friedman2, Petter Bjornstad3
1Department of Clinical Pharmacology and Pharmacy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Journal of the American Society of Nephrology : JASN
|June 13, 2025
Abstract
No abstract available in PubMed .
Insights
Tirzepatide significantly reduced albuminuria in individuals with overweight or obesity, with or without type 2 diabetes. Kidney function, measured by estimated glomerular filtration rate (eGFR), showed no adverse changes with tirzepatide treatment.
Area of Science:
- Endocrinology
- Nephrology
- Metabolic Diseases
Background:
- Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has demonstrated kidney protective effects in type 2 diabetes patients with high cardiovascular risk.
- This study investigates tirzepatide's impact on kidney function in individuals with overweight/obesity, both with and without type 2 diabetes.
Purpose of the Study:
- To assess the association between tirzepatide use and kidney function parameters, specifically urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR).
- To evaluate these effects in two distinct populations: those with overweight/obesity without type 2 diabetes (SURMOUNT-1) and those with type 2 diabetes (SURMOUNT-2).
Main Methods:
- Post hoc analysis of the SURMOUNT-1 and SURMOUNT-2 randomized controlled trials.
- Participants received tirzepatide (5, 10, or 15 mg) or placebo, with tirzepatide groups pooled within each trial.
- Key assessments included changes in UACR and eGFR (using creatinine, cystatin-C, and combined equations) from baseline to week 72.
Main Results:
- Tirzepatide use was associated with a significant reduction in UACR at week 72 compared to placebo in both trials (-8.4% in SURMOUNT-1, -31.1% in SURMOUNT-2).
- Reductions in UACR were more pronounced in participants with higher baseline UACR (≥30 mg/g).
- Tirzepatide was linked to increased eGFR (cystatin-C-based) in SURMOUNT-1, but no significant between-group differences in eGFR changes were observed in SURMOUNT-2.
Conclusions:
- Tirzepatide demonstrates a beneficial effect on albuminuria in individuals with overweight/obesity, irrespective of type 2 diabetes status.
- The treatment was not associated with adverse effects on estimated glomerular filtration rate.
- These findings support tirzepatide's potential role in managing kidney health in this patient population.
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