{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T09:54:43Z","timestamp":1794304483137,"version":"4.9.0"},"reference-count":50,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec id=\"ab-ioi250091-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>No randomized clinical trial has directly compared the effectiveness of sodium-glucose cotransporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment in reducing acute and chronic kidney outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi250091-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the comparative effectiveness of SGLT2i and GLP-1RA treatment for acute and chronic kidney outcomes in individuals with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi250091-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This comparative effectiveness study with a target trial emulation design used nationwide, population-based data from Denmark. Participants were individuals with metformin-treated type 2 diabetes who initiated SGLT2i or GLP-1RA treatment from January 2014 to November 2020, with follow-up through October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi250091-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Initiation of an SGLT2i or a GLP-1RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi250091-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The 2 coprimary outcomes were chronic kidney disease (CKD; 40% reduction in estimated glomerular filtration rate [eGFR], severe albuminuria, or kidney failure) and acute kidney injury (AKI). Secondary outcomes included the individual components of CKD, albuminuria, and death. Intention-to-treat effects were estimated using inverse probability of treatment weights, comparing risks for CKD assessed by the Aalen-Johansen estimator, and AKI burden by mean cumulative counts (MCCs; mean number of events per individual as multiple AKI events were possible). Subgroup analyses included stratification by preexisting cardiovascular or kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi250091-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 36\u202f279 individuals who initiated an SGLT2i and 18\u202f782 who initiated a GLP-1RA (median [IQR] age, 63 [55-71] years vs 61 [52-70] years), with comparable diabetes duration, eGFR, and urine albumin-creatinine ratios. The weighted 5-year risk of CKD was 6.7% (95% CI, 6.4%-7.0%) for SGLT2i initiators and 8.2% (95% CI, 7.8%-8.6%) for GLP-1RA initiators (risk ratio: 0.81 [95% CI, 0.76-0.87]; risk difference: \u22121.5% [95% CI, \u22122.0% to \u22121.0%]). The 5-year MCC of AKI per 100 individuals was 25.2 (95% CI, 24.4-26.1) for SGLT2i initiators and 28.7 (95% CI, 27.4-30.0) for GLP-1RA initiators (MCC ratio: 0.88 [95% CI, 0.83-0.93]; MCC difference: \u22123.5 [95% CI, \u22125.0 to \u22122.0]). In contrast, the secondary outcomes of albuminuria and mortality were slightly reduced in GLP-1RA initiators. Results were consistent across subgroups, with the most pronounced CKD and AKI reductions with SGLT2i observed among individuals without preexisting kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi250091-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This comparative effectiveness study found that initiation of SGLT2i vs GLP-1RA treatment in individuals with type 2 diabetes was associated with a lower 5-year risk of CKD and a lower 5-year count of AKI. These findings underscore the potential of SGLT2i treatment for primary prevention of kidney disease in individuals with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamainternmed.2025.7409","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:00:30Z","timestamp":1768924830000},"page":"353","source":"Crossref","is-referenced-by-count":13,"title":["SGLT2 Inhibitors vs GLP-1 Receptor Agonists for Kidney Outcomes in Individuals With Type 2 Diabetes"],"prefix":"10.1001","volume":"186","author":[{"given":"Simon K.","family":"Jensen","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"},{"name":"Department of Anesthesiology and Intensive Care, Regional Hospital Viborg, Viborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uffe","family":"Heide-J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina T.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper","family":"Bonnesen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"},{"name":"Department of Clinical Pharmacology, Copenhagen University Hospital, Copenhagen, Denmark"},{"name":"Department of Cardiology, Regional Hospital G\u00f8dstrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard L.","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands"},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reimar W.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian F.","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"ioi250091r1","doi-asserted-by":"publisher","first-page":"S140","DOI":"10.2337\/dc23-S009","article-title":"9. 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