Comparative risk of infections with GLP-1 receptor agonists versus SGLT2 inhibitors in patients with advanced chronic kidney disease and type 2 diabetes
Main finding · Overall infectionResult — go to the resultHazard ratio 1.04 95% CI 1.00–1.07Authors' conclusion
In patients with T2DM and advanced CKD, GLP-1 RAs were associated with higher risks of select infections compared to SGLT2i. These findings highlight the need for careful infection monitoring in this vulnerable population.
Study context
- Population
- Adults with T2D and eGFR ≤ 45 mL/min/1.73 m², 2016 to 2023, TriNetX U.S. Collaborative Networkafter propensity score matching
- Participants
- 22,393 adults
- Exposure
- GLP-1 RAs vs SGLT2 inhibitors (SGLT2i)
- Outcome
- Overall infection risk
- Follow-up
- 4-year follow-up
Methodological details1:1 propensity score matched, TriNetX U.S. Collaborative Network
- 1:1 propensity score matched
- TriNetX U.S. Collaborative Network
Main finding
Overall infection
Hazard ratio
1.04
95% CI 1.00–1.07
P = 0.044
GLP-1 RAsvs SGLT2i
HR 1.04 (95% CI 1.00–1.07); P = 0.044
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Specific infectionsBetween GLP-1 RAs and SGLT2i | HR, biliary tract infections 1.37 |
| Specific infectionsBetween GLP-1 RAs and SGLT2i | HR, catheter-related infections 1.34 |
| Specific infectionsBetween GLP-1 RAs and SGLT2i | HR, infective endocarditis 1.31 |
Specific infections
- No differences in pneumonia, sepsis or urinary tract infections
Subgroups (age, sex, BMI, cardiovascular status)
- Consistent trends across age, sex, BMI and cardiovascular status
Original publication
Comparative risk of infections with GLP-1 receptor agonists versus SGLT2 inhibitors in patients with advanced chronic kidney disease and type 2 diabetes. Diabetes Res Clin Pract. Published 27 January 2026. doi:10.
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