Patients already on GLP-1 drugs showed enhanced albuminuria reduction and maintained safety when adding another kidney-protective therapy, suggesting additive renal benefits.
Additive kidney protectionGLP-1 drugs enhanced albuminuria reduction when combined with other kidney-protective therapies, supporting multi-drug approaches
What the researchers found
Baseline GLP-1 RA use enhanced albuminuria reduction when combined with additional kidney-protective therapy, with maintained safety profile.
Why it matters
Kidney disease patients often need multiple protective therapies. Showing that GLP-1 drugs add to other kidney protections supports multi-drug approaches to preserving kidney function.
The numbers in context
Patients had CKD with UACR ≥100. Urinary albumin-to-creatinine ratio was the primary outcome. Analysis stratified by baseline GLP-1 RA use.
How the study worked
Analysis of albuminuria reduction and safety outcomes stratified by baseline GLP-1 RA use status in a kidney protection trial.
Who was studied
Adults with type 2 diabetes and chronic kidney disease (UACR ≥100) in the CONFIDENCE trial
What this study cannot tell us
Post-hoc analysis of a trial. Baseline GLP-1 users may differ from non-users in other ways. The specific combination therapy is not detailed in this preview.
How to read the evidence
Moderate evidence: post-hoc analysis from a kidney trial showing enhanced outcomes with GLP-1 baseline use.
When this study was published
Published in 2025. Supports multi-drug kidney protection strategies including GLP-1 drugs.
The bigger picture
Kidney protection is moving toward multi-drug regimens analogous to cardiovascular risk management. GLP-1 drugs, SGLT2 inhibitors, and finerenone may all be combined for optimal kidney protection — and this study shows they can safely work together.
Questions still open
- What is the optimal multi-drug kidney protection regimen including GLP-1 drugs?
- Do all GLP-1 drugs provide equal additive kidney protection?
- Should GLP-1 drugs be started early in CKD specifically for albuminuria reduction?
Common questions
Can GLP-1 drugs be combined with other kidney drugs?
What is albuminuria and why does it matter?
Read the original research
Impact of Baseline GLP-1 Receptor Agonist Use on Albuminuria Reduction and Safety With Simultaneous Initiation of Finerenone and Empagliflozin in Type 2 Diabetes and Chronic Kidney Disease (CONFIDENCE Trial).
Diabetes care, 48(11), 1904-1913
Citation
Agarwal, Rajiv; Green, Jennifer B; Heerspink, Hiddo J L; Mann, Johannes F E; McGill, Janet B; Mottl, Amy K; Nangaku, Masaomi; Rosenstock, Julio; Vaduganathan, Muthiah; Brinker, Meike; Scott, Charlie; Li, Li; Li, Na; Rohwedder, Katja; Rossing, Peter. (2025). Impact of Baseline GLP-1 Receptor Agonist Use on Albuminuria Reduction and Safety With Simultaneous Initiation of Finerenone and Empagliflozin in Type 2 Diabetes and Chronic Kidney Disease (CONFIDENCE Trial).. Diabetes care, 48(11), 1904-1913. https://doi.org/10.2337/dc25-1673