Diabetes Drugs Shield Kidneys, Study Finds

Diabetes and obesity drugs have been found to reduce the risk of kidney failure and protect cardiovascular health in people with and without diabetes.

Popular diabetes drugs like Ozempic can reduce the risk of kidney failure and death due to kidney or cardiovascular causes in people with and without diabetes, a new study shows.

The drugs reduce the risk of kidney failure by 16%, the risk of worsening kidney function by 22% and the risk of cardiovascular death, non-fatal heart attack, and non-fatal stroke by 14%.

The findings, published in The Lancet Diabetes & Endocrinology journal on Tuesday, come from a meta-analysis of 11 large-scale clinical trials, involving more than 85,000 people, of which about 67,770 had type 2 diabetes, and 17,600 did not, but were overweight or obese and had cardiovascular disease.

The trials investigated seven different glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide, more commonly known by brand names Ozempic or Wegovy, dulaglutide (Trulicity) and liraglutide (Victoza). Findings from the FLOW trial, one of the seven included in the analysis, were published earlier this year.

The new study is the largest analysis of the medication's impact on kidney and cardiovascular outcomes to date. While its benefits for the treatment of type 2 diabetes, obesity and cardiovascular disease are well known, its impact on chronic kidney disease (CKD) has been less certain.

"This is the first study to show a clear benefit of GLP-1 receptor agonists on kidney failure or end-stage kidney disease," said lead author Dr Sunil Badve, a UNSW Sydney Conjoint Professor and Professorial Fellow at The George Institute for Global Health.

"It suggests they have a key role in kidney-protective and heart-protective treatment for patients with common medical conditions like type 2 diabetes, overweight or obesity with cardiovascular disease, or CKD."

Drug could help the one in 10 people with chronic kidney disease

Originally developed to treat diabetes, GLP-1 receptor agonists mimic the action of a hormone called glucagon-like peptide 1, which stimulates insulin production and lowers blood sugar levels. More recently, they have emerged as effective treatments for obesity - slowing digestion, increasing feelings of fullness, and reducing hunger.

The meta-analysis showed that overall GLP-1 receptor agonists delivered a combined reduction of 19% for kidney failure, worsening kidney function and death due to kidney disease. Death by any cause was also 13% lower among patients treated with GLP-1 receptor agonists instead of a placebo.

"These results are particularly important for patients with chronic kidney disease. It is a progressive condition eventually leading to kidney failure requiring dialysis or kidney transplantation and is associated with premature death, mostly from heart disease. It has a significant impact on patients' quality of life and incurs substantial healthcare costs," said Prof. Badve.

CKD is estimated to affect one in ten people worldwide, equivalent to around 850 million people. It is the tenth leading cause of death and is projected to become the fifth most common cause of death by 2050. Diabetes, cardiovascular disease and obesity are independent risk factors for CKD and represent a major global health burden.

Senior author Scientia Professor Vlado Perkovic, Provost at UNSW and Professorial Fellow at The George Institute, said the research showed GLP-1 receptor agonists could play an important role in addressing the global burden of non-communicable diseases.

"Our study will have a major impact on clinical guidelines for the management of chronic kidney disease and cardiovascular disease in people with and without diabetes," he said.

"More work is now needed to implement the results of this study into clinical practice and improve access to GLP-1 receptor agonists to people who will benefit from them," he added.

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