GLP-1 agonists in the treatment of chronic kidney disease in type 2 diabetes and obesity

J Clin Invest. 2025 Nov 3;135(21):e194749. doi: 10.1172/JCI194749.

Abstract

Glucagon-like peptide-1 (GLP-1) was initially considered to be a hormone with a predominant role in regulating glucose metabolism by inducing insulin secretion, reducing glucagon secretion, and ameliorating insulin resistance, with the last effect being largely dependent on the induction of weight loss. In more recent years, the role of this peptide beyond metabolism has progressively been explored, including its impact on kidney physiology and kidney clinical outcomes in people with obesity with or without diabetes. Indeed, despite only modest expression of the GLP-1 receptor in the kidney, the renoprotective actions of GLP-1 and its receptor agonists have become an area of intensive investigation. This Review appraises the current status of GLP-1 peptide and its receptor agonists and focuses on the preclinical as well as recent seminal clinical findings defining the kidney benefits conferred by GLP-1 receptor agonist treatment in people living with type 2 diabetes and obesity.

Publication types

  • Review

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetic Nephropathies* / drug therapy
  • Diabetic Nephropathies* / metabolism
  • Glucagon-Like Peptide 1* / agonists
  • Glucagon-Like Peptide 1* / metabolism
  • Glucagon-Like Peptide-1 Receptor / metabolism
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Obesity* / complications
  • Obesity* / drug therapy
  • Obesity* / metabolism
  • Renal Insufficiency, Chronic* / drug therapy
  • Renal Insufficiency, Chronic* / metabolism

Substances

  • Glucagon-Like Peptide 1
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Glucagon-Like Peptide-1 Receptor
  • GLP1R protein, human
  • Hypoglycemic Agents