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Current Insights and Future Directions on the Role of GLP-1 Receptor Agonists in Chronic Kidney Disease

Kavya Rajan1, Arjun Krishen Jutley2, Michael W Holliday3,4

  • 1Innovation Academy High School, Alpharetta, GA, USA.

International Journal of Nephrology and Renovascular Disease
|March 30, 2026
PubMed

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) significantly benefit patients with chronic kidney disease (CKD) and type 2 diabetes. These therapies improve mortality, cardiovascular health, and slow kidney function decline.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiology

Background:

  • Chronic kidney disease (CKD) incidence is rising, particularly in patients with obesity and diabetes, leading to significant patient burdens.
  • Current CKD management includes ACEI/ARB, SGLT2 inhibitors, and mineralocorticoid receptor antagonists.
  • Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly recognized for their benefits beyond glycemic control.

Purpose of the Study:

  • To review recent advances in understanding the kidney benefits of GLP-1 agonism in high-risk populations.
  • To discuss the role of GLP-1RAs in patients with type 2 diabetes mellitus, obesity, and cardiovascular disease.
  • To highlight the implications of new guidelines recommending GLP-1RA therapy for specific CKD populations.

Main Methods:

  • Review of renal signals from cardiovascular outcomes trials involving GLP-1RA therapy.
  • Analysis of dedicated kidney outcome studies, including trials with semaglutide.
  • Examination of current and emerging GLP-1-based therapies.

Main Results:

  • GLP-1RA therapy demonstrated reduced albuminuria and slower estimated glomerular filtration rate (eGFR) decline.
  • Benefits were often additive to sodium-glucose cotransporter-2 inhibition.
  • Semaglutide was shown to slow CKD progression and lower mortality in diabetic patients with CKD.

Conclusions:

  • GLP-1-based therapies offer a transformative strategy for managing weight, cardiovascular health, and kidney outcomes in diabetic CKD patients.
  • Future research should explore GLP-1RA use in non-diabetic CKD patients and evaluate dual/triple agonists and oral formulations.
  • GLP-1RAs are a cornerstone therapy for improving mortality and cardiorenal outcomes in high-risk populations.
Keywords:
cardiorenal outcomeschronic kidney diseasediabetesnephroprotectionobesity

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