GLP-1 Agonists Reduce Kidney Disease Risk, Offering Benefits Beyond Diabetes Management

A groundbreaking meta-analysis has revealed that glucagon-like peptide-1 (GLP-1) receptor agonists may be able to reduce the risk of kidney failure and cardiovascular events, even in individuals without diabetes. Published in The Lancet Diabetes & Endocrinology, the study evaluated over 85,000 participants, highlighting the broad potential of these drugs in protecting kidney and heart health.

New Evidence on Kidney Health

GLP-1 receptor agonists, originally designed to manage type 2 diabetes by lowering blood sugar levels, have also become popular treatments for obesity due to their ability to reduce appetite and promote weight loss. This new analysis, however, sheds light on their lesser-known kidney-protective effects.

Researchers reviewed 11 large-scale clinical trials involving 85,373 participants, including 67,769 with type 2 diabetes and 17,604 with obesity or cardiovascular disease but no diabetes. Seven different GLP-1 receptor agonists were studied, such as semaglutide (Ozempic, Wegovy), dulaglutide (Trulicity), and liraglutide (Victoza).

Compared to placebo, GLP-1 receptor agonists:

• Reduced the risk of kidney failure by 16%.
• Lowered the likelihood of significant kidney function decline (defined as a drop in estimated glomerular filtration rate [eGFR] of 50% or more) by 22%.
• Decreased the combined risk of kidney failure, worsening kidney function, and death due to kidney disease by 19%.

“These results are particularly important for patients with chronic kidney disease," said lead author Professor Sunil Badve, Professorial Fellow at The George Institute for Global Health and UNSW Sydney. "It is a progressive condition eventually leading to kidney failure requiring dialysis or kidney transplantation and is associated with premature death, mostly from heart disease."

Implications for Global Health

Chronic kidney disease (CKD) affects approximately 850 million people worldwide, or one in ten individuals. It is the 10th leading cause of death globally and is projected to become the 5th most common cause by 2050. CKD often develops alongside conditions such as diabetes, cardiovascular disease, and obesity, all of which represent major global health challenges.

The analysis also confirmed GLP-1 receptor agonists’ cardiovascular benefits, with a 14% reduction in the risk of cardiovascular death, non-fatal heart attack, and non-fatal stroke. Death from any cause was 13% lower among patients treated with these medications.

“This is the first study to show a clear benefit of GLP-1 receptor agonists on kidney failure or end-stage kidney disease, suggesting they have a key role in kidney-protective and heart-protective treatment for patients with common medical conditions like type 2 diabetes, overweight or obesity with cardiovascular disease, or CKD,” Badve added.

Senior author Professor Vlado Perkovic, Provost at UNSW Sydney and Professorial Fellow at The George Institute, stated, “This research shows that GLP-1 receptor agonists could play an important role in addressing the global burden of non-communicable diseases. Our study will have a major impact on clinical guidelines for the management of chronic kidney disease and cardiovascular disease in people with and without diabetes.”

Moving Forward

While these findings could transform treatment guidelines for CKD and cardiovascular disease, Perkovic emphasized the need for further action: “More work is now needed to implement the results of this study into clinical practice and improve access to GLP-1 receptor agonists to people who will benefit from them.”

For healthcare professionals, this study underscores the expanding role of GLP-1 receptor agonists, not just in managing diabetes and obesity but also as a critical intervention for reducing the burden of CKD and cardiovascular disease.