GLP-1 Drugs Associated with Fewer Infections Than SGLT2 Inhibitors in Advanced Kidney Disease | Research

The takeaway

GLP-1 RAs were associated with lower infection risk compared to SGLT2 inhibitors in T2D patients with advanced CKD, particularly for urinary tract and genital infections.

Fewer infections
GLP-1 drugs had lower infection risk than SGLT2 inhibitors in advanced kidney disease, important for infection-prone patients

What the researchers found

GLP-1 RAs associated with lower risk of infections compared to SGLT2i in T2D patients with advanced CKD, particularly urinary tract and genital infections.

Why it matters

Infections are a major cause of morbidity in CKD. Choosing drugs that minimize infection risk is important for this vulnerable population.

How the study worked

Comparative effectiveness study of infection risk between GLP-1 RA and SGLT2i users in T2D patients with advanced CKD.

What this study cannot tell us

Observational study. Cannot determine causation. Infection definitions may vary. Advanced CKD patients are inherently infection-prone.

How to read the evidence

Comparative effectiveness study. Important for drug selection in vulnerable CKD population.

When this study was published

Published in 2025.

The bigger picture

Drug selection for advanced CKD must consider infection risk alongside metabolic and renal benefits — GLP-1 drugs appear safer in this regard.

Questions still open

Should GLP-1 drugs be preferred over SGLT2i in infection-prone CKD patients?
Does the infection risk difference translate to hospitalization or mortality differences?
Would combining lower-dose SGLT2i with GLP-1 RA mitigate infection risk?

Common questions

Do GLP-1 drugs cause fewer infections than SGLT2 inhibitors?

Yes, in kidney disease patients. SGLT2 drugs excrete sugar in urine, promoting urinary and genital infections. GLP-1 drugs don't have this effect, making them safer for infection-prone patients.

Should kidney patients choose GLP-1 over SGLT2 drugs?

For patients at high infection risk, GLP-1 drugs may be preferred. However, both drug classes have kidney benefits, and the choice should consider individual patient factors.

Read the original research

Comparative risk of infections with GLP-1 receptor agonists versus SGLT2 inhibitors in patients with advanced chronic kidney disease and type 2 diabetes.

Diabetes research and clinical practice, 233, 113115

View on PubMed ↗Publisher’s paper ↗

Citation

Hsiao, Ching Chung; Chen, Jia-Jin; Huang, Shu-Chun; Yen, Chieh-Li; Ho, Wen-Yu; Fang, Yu-Wei; Chen, Mon-Ting; Yang, Jeng How; Tsai, Ming-Hsien. (2026). Comparative risk of infections with GLP-1 receptor agonists versus SGLT2 inhibitors in patients with advanced chronic kidney disease and type 2 diabetes.. Diabetes research and clinical practice, 233, 113115. https://doi.org/10.1016/j.diabres.2026.113115