SGLT2 Inhibitors vs GLP-1 Receptor Agonists for Kidney Outcomes in Individuals With Type 2 Diabetes
Authors' conclusion
This comparative effectiveness study found that initiation of SGLT2i vs GLP-1RA treatment in individuals with type 2 diabetes was associated with a lower 5-year risk of CKD and a lower 5-year count of AKI. These findings underscore the potential of SGLT2i treatment for primary prevention of kidney disease in individuals with type 2 diabetes.
Study context
- Population
- Individuals with metformin-treated T2D initiating SGLT2i or GLP-1RA, January 2014 to November 2020, Denmark; follow-up through October 2024
- Participants
- 36,279 vs 18,782
- Exposure
- SGLT2i vs GLP-1 RA initiation
- SGLT2in = 36,279
- GLP-1RAn = 18,782reference
- Outcome
- Coprimary: CKD (40% reduction in eGFR, severe albuminuria, or kidney failure) and acute kidney injury (AKI)
- Follow-up
- 5 years
Methodological detailsnationwide, population-based, inverse probability of treatment weighting, intention-to-treat
- Nationwide
- Population-based
- Inverse probability of treatment weighting
- Intention-to-treat
Main finding
As reported in the abstract
- Intention-to-treat
Observational data: associations, not effects.
Secondary outcomes
Albuminuria and mortality
- Albuminuria and mortality were slightly reduced in GLP-1RA initiators
Subgroups (preexisting cardiovascular or kidney disease)
- Results consistent across subgroups; most pronounced chronic kidney disease (CKD) and acute kidney injury (AKI) reductions with SGLT2i in those without preexisting kidney disease
Original publication
SGLT2 Inhibitors vs GLP-1 Receptor Agonists for Kidney Outcomes in Individuals With Type 2 Diabetes. JAMA Intern Med. Published 1 March 2026. doi:10.
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