InterventionsHumans112,596 participantsCohort study

GLP-1 drugs added to SGLT2 inhibitors linked to lower kidney risk

Adding a GLP-1 receptor agonist was linked to lower rates of major adverse kidney events (HR 0.70) compared with SGLT2 inhibitor monotherapy over 12 months.

Diabetes, Obesity & Metabolism4 Oct 2026, 09:00 BST

In adults with chronic kidney disease, researchers evaluated whether adding a glucagon-like peptide-1 receptor agonist (GLP-1RA) to sodium-glucose co-transporter-2 inhibitor (SGLT2i) therapy improved outcomes. Using the TriNetX Global Collaborative Network from June 2020 to December 2023, investigators propensity-score matched 16,224 patients taking both drugs with 16,224 patients taking SGLT2i monotherapy.

Over a median 12-month follow-up, combination therapy was associated with lower rates of major adverse kidney events (HR 0.70; 95% CI 0.65–0.74). It was also linked to lower risks of major adverse cardiovascular events (HR 0.83; 95% CI 0.78–0.87) and all-cause mortality (HR 0.55; 95% CI 0.50–0.61). Associations were more pronounced in patients with obesity, heart failure, and ischemic heart disease. The combination was linked to more gastrointestinal symptoms, genital infections, and retinopathy progression, but fewer acute kidney injury events.

Why it matters

Age-related renal and cardiovascular deterioration are major contributors to late-life morbidity and mortality. These findings suggest that combining two metabolic therapies may offer additive cardiorenal benefits, particularly in high-risk patients with obesity.

Caveats

The study relied on a retrospective observational design with a relatively short median follow-up of 12 months, meaning residual confounding cannot be ruled out and causality cannot be established. Randomized controlled trials are needed to assess long-term safety and effectiveness.