Kidney effects of tirzepatide across albuminuria, filtration markers, and clinical outcomes: a parent-trial-level systematic review and meta-analysis
Authors' conclusion
Albuminuria lowering versus insulin was reproducible; hard-outcome benefit was population- and endpoint-dependent, and dedicated kidney-outcome trials remain needed.
Study context
- Population
- Randomized reports of tirzepatide mapped to independent parent trials providing kidney data; PubMed, Embase, and the Cochrane Library searched through August 2026parent trials provided kidney data, eight informed each principal synthesis
- Participants
- 10 participants
- Comparison
- Tirzepatide versus insulin, placebo, or dulaglutide
- Outcome
- Urinary albumin-to-creatinine ratio, versus insulin
Methodological detailsparent-trial-level
- Parent-trial-level
Pooled result
As reported in the abstract
Reduction in urinary albumin-to-creatinine ratio with tirzepatide versus insulin
27.0%
95% CI 16.0%–36.6%
Further pooled results
| Outcome | Hazard ratio (CI) | |
|---|---|---|
| Hard-only composite, SURPASS-CVOT high-risk stratumTirzepatidevs dulaglutide | 0.70 (0.57–0.86) | |
| End-stage kidney disease, SURPASS-CVOT high-risk stratumTirzepatidevs dulaglutideNot clearly reduced | 1.04 (0.70–1.55) | |
| 0.512Hazard ratio (log scale) |
- Hard-only composite, SURPASS-CVOT high-risk stratum: approximate post hoc aggregate contrasts, multiplicity-unadjusted and not formal individual-participant interaction tests
Urinary albumin-to-creatinine ratio, placebo-controlled evidence
- Placebo-controlled evidence was uncertain
- −18.1%; 95% CI, −43.2% to 18.3%
- Very low certainty
Fixed-time creatinine-based estimated glomerular filtration rate
- No clear benefit
- 0.36 mL/min/1.73 m²; 95% CI, −0.34 to 1.07
- Low certainty
SURPASS-CVOT risk-stratum contrasts
- Approximate post hoc aggregate contrasts suggested larger high-risk effects for filtration and a hard-only composite
- Multiplicity-unadjusted and not formal individual-participant interaction tests
Original publication
Kidney effects of tirzepatide across albuminuria, filtration markers, and clinical outcomes: a parent-trial-level systematic review and meta-analysis. Diabetes Res Clin Pract. Published 13 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →