J Korean Diabetes.  2025 Mar;26(1):5-9. 10.4093/jkd.2025.26.1.5.

The Role of GLP-1 Receptor Agonists in Diabetic Kidney Disease: Recent Evidence

• Kim JH

• KMID: 2567084
• DOI: http://doi.org/10.4093/jkd.2025.26.1.5

Abstract

Diabetic kidney disease (DKD) is a major cause of end-stage renal disease and a key driver of morbidity and mortality in individuals with type 2 diabetes (T2D). Despite established therapies, including renin-angiotensin-aldosterone system inhibitors and sodium glucose cotransporter 2 inhibitors, many patients continue to experience progressive kidney function decline. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) like semaglutide have demonstrated potential kidney-protective effects independent of their glucose-lowering properties through mechanisms that include reducing inflammation, oxidative stress, and fibrosis. The FLOW (Research study to see how semaglutide works compared to placebo in people with type 2 diabetes and chronic kidney disease) trial provided the first large-scale evidence that semaglutide slows the progression of chronic kidney disease in individuals with T2D, reducing the risk of clinically significant kidney outcomes by 24%. These findings suggest that GLP-1RAs may play an increasingly important role in DKD management, complementing existing therapies. This review examines the mechanisms underlying GLP-1RA-mediated kidney protection, summarizes recent clinical trial data, and discusses the implications for future treatment strategies.

Keyword

Diabetic nephropathies; Glucagon-like peptide-1 receptor agonists; Semaglutide

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