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Study breakdown

SGLT2i vs GLP-1 RA for Kidney Outcomes: Head-to-Head Comparison in Real-World T2D

evidence
The takeaway

SGLT2 inhibitors and GLP-1 RAs showed differential kidney outcome benefits in individuals with T2D, with comparative effectiveness varying by baseline kidney function and risk profile.

Kidney drugs compared

SGLT2 inhibitors and GLP-1 drugs protect kidneys differently depending on the patient's baseline kidney function

What the researchers found

SGLT2i and GLP-1 RA showed differential kidney outcome profiles in T2D, with comparative effectiveness varying by baseline kidney function and patient risk characteristics.

Why it matters

Kidney disease is the leading cause of T2D complications. Choosing the right drug for kidney protection could prevent dialysis.

How the study worked

Comparative effectiveness study of SGLT2i vs GLP-1 RA for kidney outcomes in T2D patients.

What this study cannot tell us

Details in full paper. Observational comparisons have inherent confounding.

How to read the evidence

Large comparative effectiveness study.

When this study was published

Published in 2025.

The bigger picture

Personalizing kidney-protective drug selection based on individual kidney risk represents precision nephrology.

Questions still open

  • Should KFRE guide drug selection for kidney protection?
  • Would combining both drugs provide additive kidney benefit?
  • At what eGFR level does one drug clearly outperform the other?

Common questions

Which diabetes drug is better for kidneys?
It depends on your kidney health. This study found SGLT2 inhibitors and GLP-1 drugs protect kidneys differently based on how advanced kidney disease is at treatment start.
Should I take both?
Possibly. Combining them may provide additive kidney protection. Your nephrologist can determine the best strategy based on your specific kidney risk.

Read the original research

SGLT2 Inhibitors vs GLP-1 Receptor Agonists for Kidney Outcomes in Individuals With Type 2 Diabetes.

JAMA internal medicine, 186(3), 353-361

Citation

Jensen, Simon K; Heide-Jørgensen, Uffe; Andersen, Ina T; Bonnesen, Kasper; Fu, Edouard L; Thomsen, Reimar W; Christiansen, Christian F. (2026). SGLT2 Inhibitors vs GLP-1 Receptor Agonists for Kidney Outcomes in Individuals With Type 2 Diabetes.. JAMA internal medicine, 186(3), 353-361. https://doi.org/10.1001/jamainternmed.2025.7409