Major advancements in slowing diabetic kidney disease progression: focus on SGLT2 inhibitors
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GLP-1 RAs reduce risks of CVD events and hypoglycemia and slow progression of CKD.
“GLP-1 RAs are suggested for cardiovascular risk reduction if such risk is a predominant problem, as they reduce risks of CVD events and hypoglycemia and slow progression of CKD (100,107-110).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [110]
In the main text (page unavailable), Bakris reports that GLP-1 receptor agonist trials reduced cardiovascular event rates and albuminuria, and describes kidney-progression benefits as promising. The paper does not report reduced hypoglycemia risk or establish that GLP-1 receptor agonists slow CKD progression; it attributes the observed slowing of kidney disease progression to SGLT2 inhibitor trials. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBased on evidence from the CREDENCE, DAPA-CKD, and EMPA-KIDNEY trials, as well as secondary analyses of cardiovascular outcomes trials with SGLT2 inhibitors, cardiovascular and renal events are reduced with SGLT2 inhibitor use in individuals with an eGFR ≥20 mL/min/1.73m2, independent of glucose-lowering effects.
“Based on evidence from the CREDENCE, DAPA-CKD, and EMPA-KIDNEY trials, as well as secondary analyses of cardiovascular outcomes trials with SGLT2 inhibitors, cardiovascular and renal events are reduced with SGLT2 inhibitor use in individuals with an eGFR of 20 mL/min/1.73m 2 , independent of glucose-lowering effects (110,113).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [110]
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Experimental — accuracy not yet measuredIn CREDENCE, there were clear benefits on cardiovascular outcomes demonstrating a 31% reduction in cardiovascular death or heart failure hospitalization and a 20% reduction in cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.
“Moreover, in this advanced CKD group, there were clear benefits on cardiovascular outcomes demonstrating a 31% reduction in cardiovascular death or heart failure hospitalization and a 20% reduction in cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (29,110,113).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [110]
The main text (page not provided) describes CREDENCE and says SGLT2 inhibitors reduce cardiovascular risk in people with type 2 diabetes. It does not report either the 31% reduction in cardiovascular death or heart-failure hospitalization or the 20% reduction in cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Its 31% figure instead refers to the proportion of CREDENCE participants with CKD stages 3b–4. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn CREDENCE, there was a 31% reduction in cardiovascular death or heart failure hospitalization and a 20% reduction in cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.
“there were clear benefits on cardiovascular outcomes demonstrating a 31% reduction in cardiovascular death or heart failure hospitalization and a 20% reduction in cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (29,125,126).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [125]
The main text says CREDENCE supports reduced cardiovascular risk in people with type 2 diabetes, but it does not report either the 31% reduction in cardiovascular death or heart-failure hospitalization or the 20% reduction in cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Searches for both outcome phrases found no matching figures; the text’s 31% refers instead to the proportion of CREDENCE participants with CKD stages 3b–4. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMost GLP-1 RAs may be used at low eGFR for cardiovascular protection but may require dose adjustment.
“Of note, most GLP-1 RAs may also be used at low eGFR for cardiovascular protection but may require dose adjustment (125).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [125]
The paper's main text (page not provided) reports that GLP-1 receptor agonists reduced cardiovascular event rates in outcome trials. It does not say that most can be used at low eGFR or that dose adjustment may be required; its discussion of low eGFR concerns SGLT2 inhibitors. (LLM, conf=0.88)
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References 20 · Cited by 37
- Authors
- Bakris, G. L.
- Affiliations
- American Heart Association (US)
- Corresponding author
- Bakris, George L.
- ORCID
- Bakris, George L.
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 74
- Issue
- 5
- Pages
- 573-575
- ISSN
- 0272-6386 (ISSN-L)
- OpenAlex
- W2953884115
- Cited by
- 37
- References
- 20
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 11 · 2019: 2
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Chicago
- AstraZeneca
- Janssen Pharmaceuticals
- Sanofi
- Bayer Fund
- Boehringer Ingelheim
- Novo Nordisk
- Pfizer
- AbbVie
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- diabetic nephropathy, SGLT2 inhibitors, albuminuria, disease progression, type 2 diabetes, renin-angiotensin system inhibitors, end-stage renal disease, albumin excretion
- MeSH terms
- Sodium-Glucose Transporter 2 Inhibitors, Diabetic Nephropathies, Humans, Treatment Outcome, Disease Progression
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