{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:55:11Z","timestamp":1789620911597,"version":"build-2803163510"},"reference-count":92,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Renal Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>The interrelated pandemics of obesity and type 2 diabetes mellitus (T2DM) are fuelling an increase in the prevalence of chronic kidney disease (CKD), which amplifies the risk of cardiovascular events and may progress to end-stage kidney disease (ESKD). Treatment options for such patients have rapidly expanded over the past decade and continue to evolve. Herein, we primarily focus on glucagon-like peptide-1 receptor agonists (GLP-1RAs) and their role in the management of CKD in the setting of overweight\/obesity and T2DM. Recommendations from the recent Kidney Disease: Improving Global Outcomes CKD guidelines are summarized and new evidence arising since publication of these guidelines is highlighted. We review clinical studies supporting the role of GLP-1RAs in patients with diabesity and CKD, including the FLOW trial, as well as exploring potential mechanisms of their nephroprotective effects. Their role in the management of patients with ESKD on maintenance dialysis and after kidney transplantation, while less evidence-based, is also discussed. The potential for other gut hormone\u2013based therapies, including GLP-1\/glucose-dependent insulinotropic polypeptide dual agonists (tirzepatide), triple agonists (incorporating glucagon agonism) and amylin analogues to improve cardiovascular and kidney outcomes in patients with CKD, is explored. We highlight the role of novel therapies distinct from the gut\u2013kidney axis, including non-steroidal mineralocorticoid receptor antagonists (nsMRAs). We outline the potential for multitarget therapy incorporating renin\u2013angiotensin\u2013aldosterone system inhibitors, sodium\u2013glucose co-transporter-2 inhibitors, incretin-based treatments and nsMRAs to improve cardiovascular and kidney outcomes in patients with overweight\/obesity and T2DM. Current unknowns in the timing and sequence of multitarget therapy in patients with CKD are emphasized. Priority research questions for the future are highlighted throughout the review.<\/jats:p>","DOI":"10.1093\/ndt\/gfaf069","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T13:06:22Z","timestamp":1747141582000},"page":"1977-1988","source":"Crossref","is-referenced-by-count":8,"title":["How to individualize renoprotective therapy in obese patients with chronic kidney disease: a commentary by the Diabesity Working Group of the ERA"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5824-6973","authenticated-orcid":false,"given":"Enrique","family":"Morales","sequence":"first","affiliation":[{"name":"Hospital 12 de Octubre Department of Nephrology, , Madrid ,","place":["Spain"]},{"name":"Research Institute of University Hospital 12 de Octubre (imas12) , Department of Medicine, Complutense University of Madrid, Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William P","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Nephrology , Department of Medicine, Washington University in St. Louis, St. Louis, MO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastjan","family":"Bevc","sequence":"additional","affiliation":[{"name":"Clinic for Internal Medicine, University Medical Centre Maribor Department of Nephrology, , Maribor ,","place":["Slovenia"]},{"name":"University of Maribor Medical Faculty, , Maribor ,","place":["Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond G","family":"Jenssen","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Oslo University Hospital Rikshospitalet Department of Transplantation Medicine, , Oslo ,","place":["Norway"]},{"name":"University of Oslo Institute of Clinical Medicine, , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Miglinas","sequence":"additional","affiliation":[{"name":"Vilnius University Center of Nephrology, Santaros Klinikos, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matias","family":"Trillini","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche Mario Negri IRCCS , Bergamo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"2025092904570304300_bib1","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1681\/asn.0000000512","article-title":"ASN kidney health guidance on the management of obesity in persons living with kidney diseases","volume":"35","author":"Ikizler","year":"2024","journal-title":"J Am Soc Nephrol"},{"key":"2025092904570304300_bib2","author":"World Obesity Federation","year":"2024","journal-title":"World Obesity Atlas 2024"},{"key":"2025092904570304300_bib3","doi-asserted-by":"publisher","first-page":"e12402","DOI":"10.1111\/cob.12402","article-title":"Obesity is common in chronic kidney disease and associates with greater antihypertensive usage and proteinuria: evidence from a cross-sectional study in a tertiary nephrology centre","volume":"10","author":"Martin","year":"2020","journal-title":"Clin Obes"},{"key":"2025092904570304300_bib4","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1053\/j.ajkd.2022.06.007","article-title":"Obstacles and opportunities in managing coexisting Obesity and CKD: report of a scientific workshop cosponsored by the National Kidney Foundation and The Obesity Society","volume":"80","author":"Friedman","year":"2022","journal-title":"Am J Kidney Dis"},{"key":"2025092904570304300_bib5","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","article-title":"Definition and diagnostic criteria of clinical obesity","volume":"13","author":"Rubino","year":"2025","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025092904570304300_bib6","doi-asserted-by":"publisher","first-page":"102344","DOI":"10.1016\/j.cpcardiol.2023.102344","article-title":"Cardiovascular-Kidney-metabolic (CKM) syndrome: a state-of-the-art review","volume":"49","author":"Sebastian","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"2025092904570304300_bib7","doi-asserted-by":"publisher","first-page":"151520","DOI":"10.1016\/j.semnephrol.2024.151520","article-title":"Challenges and strategies in implementing novel kidney protective and cardioprotective therapies in patients with diabetes and kidney disease","volume":"44","author":"Limonte","year":"2024","journal-title":"Semin Nephrol"},{"key":"2025092904570304300_bib8","doi-asserted-by":"publisher","first-page":"ii19","DOI":"10.1093\/ckj\/sfae296","article-title":"GLP-1 receptor agonists in patients with chronic kidney disease and either overweight or obesity","volume":"17","author":"Abasheva","year":"2024","journal-title":"Clin Kidney J"},{"key":"2025092904570304300_bib9","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1161\/CIRCULATIONAHA.123.067584","article-title":"Estimated lifetime cardiovascular, kidney, and mortality benefits of combination treatment with SGLT2 inhibitors, GLP-1 receptor agonists, and nonsteroidal MRA compared with conventional care in patients with type 2 diabetes and albuminuria","volume":"149","author":"Neuen","year":"2024","journal-title":"Circulation"},{"key":"2025092904570304300_bib10","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.2215\/cjn.08900722","article-title":"Estimated lifetime benefit of combined RAAS and SGLT2 inhibitor therapy in patients with albuminuric CKD without diabetes","volume":"17","author":"Vart","year":"2022","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025092904570304300_bib11","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/s2213-8587(18)30268-7","article-title":"Lixisenatide and renal outcomes in patients with type 2 diabetes and acute coronary syndrome: an exploratory analysis of the ELIXA randomised, placebo-controlled trial","volume":"6","author":"Muskiet","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025092904570304300_bib12","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and cardiovascular outcomes in patients with type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib13","doi-asserted-by":"publisher","first-page":"446","DOI":"10.2337\/dc19-1065","article-title":"Microvascular and cardiovascular outcomes according to renal function in patients treated with once-weekly exenatide: insights from the EXSCEL trial","volume":"43","author":"Bethel","year":"2020","journal-title":"Diabetes Care"},{"key":"2025092904570304300_bib14","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1056\/NEJMoa1616011","article-title":"Liraglutide and renal outcomes in type 2 diabetes","volume":"377","author":"Mann","year":"2017","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib15","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1016\/S0140-6736(18)32261-X","article-title":"Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial","volume":"392","author":"Hernandez","year":"2018","journal-title":"Lancet"},{"key":"2025092904570304300_bib16","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/S0140-6736(19)31150-X","article-title":"Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial","volume":"394","author":"Gerstein","year":"2019","journal-title":"Lancet"},{"key":"2025092904570304300_bib17","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1056\/NEJMoa2108269","article-title":"Cardiovascular and renal outcomes with efpeglenatide in type 2 diabetes","volume":"385","author":"Gerstein","year":"2021","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib18","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib19","doi-asserted-by":"publisher","first-page":"2058","DOI":"10.1038\/s41591-024-03015-5","article-title":"Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial","volume":"30","author":"Colhoun","year":"2024","journal-title":"Nat Med"},{"key":"2025092904570304300_bib20","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1038\/s41591-024-03327-6","article-title":"Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial","volume":"31","author":"Apperloo","year":"2025","journal-title":"Nat Med"},{"key":"2025092904570304300_bib21","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1002\/oby.23621","article-title":"Semaglutide for cardiovascular event reduction in people with overweight or obesity: SELECT study baseline characteristics","volume":"31","author":"Lingvay","year":"2023","journal-title":"Obesity (Silver Spring)"},{"key":"2025092904570304300_bib22","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1159\/000095319","article-title":"Obesity paradox in patients on maintenance dialysis","volume":"151","author":"Kalantar-Zadeh","year":"2006","journal-title":"Contrib Nephrol"},{"key":"2025092904570304300_bib23","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1053\/j.ajkd.2010.01.017","article-title":"Obesity in kidney transplant recipients and candidates","volume":"56","author":"Potluri","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"2025092904570304300_bib24","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1016\/j.numecd.2023.03.023","article-title":"Glucagon-like peptide 1 receptor agonists in end-staged kidney disease and kidney transplantation: a narrative review","volume":"33","author":"Clemens","year":"2023","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2025092904570304300_bib25","doi-asserted-by":"publisher","first-page":"206","DOI":"10.2337\/dc15-1025","article-title":"Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease: an investigator-initiated, placebo-controlled, double-blind, parallel-group, randomized trial","volume":"39","author":"Idorn","year":"2016","journal-title":"Diabetes Care"},{"key":"2025092904570304300_bib26","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.eprac.2024.07.008","article-title":"The use of semaglutide in patients with renal failure\u2013a retrospective cohort study","volume":"30","author":"Long","year":"2024","journal-title":"Endocr Pract"},{"key":"2025092904570304300_bib27","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/osp4.84","article-title":"Liraglutide for weight management: a critical review of the evidence","volume":"3","author":"Mehta","year":"2017","journal-title":"Obes Sci Pract"},{"key":"2025092904570304300_bib28","doi-asserted-by":"publisher","first-page":"3023","DOI":"10.1681\/asn.2007070796","article-title":"Noninfectious complications of peritoneal dialysis: implications for patient and technique survival","volume":"18","author":"McCormick","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"2025092904570304300_bib29","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.2337\/dc19-0093","article-title":"Efficacy and safety of empagliflozin in renal transplant recipients with posttransplant diabetes mellitus","volume":"42","author":"Halden","year":"2019","journal-title":"Diabetes Care"},{"key":"2025092904570304300_bib30","doi-asserted-by":"publisher","first-page":"2042018819865398","DOI":"10.1177\/2042018819865398","article-title":"The incretin pathway as a therapeutic target in diabetic kidney disease: a clinical focus on GLP-1 receptor agonists","volume":"10","author":"van Baar","year":"2019","journal-title":"Ther Adv Endocrinol Metab"},{"key":"2025092904570304300_bib31","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.3390\/life13061265","article-title":"Novel drugs for the management of diabetes kidney transplant patients: a literature review","volume":"13","author":"Valencia-Morales","year":"2023","journal-title":"Life (Basel)"},{"key":"2025092904570304300_bib32","doi-asserted-by":"publisher","first-page":"e15144","DOI":"10.1111\/ctr.15144","article-title":"Sodium-glucose co-transporter 2 inhibitors & glucagon-like peptide-1 receptor agonists, efficacy & safety in diabetic kidney transplant recipients","volume":"37","author":"Mahmoud","year":"2023","journal-title":"Clin Transplant"},{"key":"2025092904570304300_bib33","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1016\/j.nefroe.2024.11.007","article-title":"Use of glucagon-like peptide type 1 receptor agonists in kidney transplant recipients","volume":"44","author":"Vigara","year":"2024","journal-title":"Nefrologia (Engl Ed)"},{"key":"2025092904570304300_bib34","doi-asserted-by":"publisher","first-page":"e121","DOI":"10.1097\/TP.0000000000004945","article-title":"Glucagon-like peptide 1 receptor agonists and cardiovascular outcomes in solid organ transplant recipients with diabetes mellitus","volume":"108","author":"Dotan","year":"2024","journal-title":"Transplantation"},{"issue":"5 Suppl","key":"2025092904570304300_bib35","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2022.06.008","article-title":"KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease","volume":"102","author":"Kidney Disease: Improving Global Outcomes Diabetes Work Group","year":"2022","journal-title":"Kidney Int"},{"issue":"4 Suppl","key":"2025092904570304300_bib36","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"key":"2025092904570304300_bib37","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.diabres.2019.02.006","article-title":"Exenatide once-weekly improves metabolic parameters, endothelial dysfunction and carotid intima-media thickness in patients with type-2 diabetes: an 8-month prospective study","volume":"149","author":"Patti","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"2025092904570304300_bib38","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1080\/17446651.2018.1518130","article-title":"Impact of bariatric surgery on cardiovascular and renal complications of diabetes: a focus on clinical outcomes and putative mechanisms","volume":"13","author":"Martin","year":"2018","journal-title":"Expert Rev Endocrinol Metab"},{"key":"2025092904570304300_bib39","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1038\/s41392-024-01931-z","article-title":"Glucagon-like peptide-1 receptor: mechanisms and advances in therapy","volume":"9","author":"Zheng","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"2025092904570304300_bib40","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.3390\/jcm10061291","article-title":"Perirenal adipose tissue\u2014current knowledge and future opportunities","volume":"10","author":"Grigora\u0219","year":"2021","journal-title":"J Clin Med"},{"key":"2025092904570304300_bib41","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1161\/hypertensionaha.111.175315","article-title":"Fatty kidney, hypertension, and chronic kidney disease: the Framingham Heart Study","volume":"58","author":"Foster","year":"2011","journal-title":"Hypertension"},{"key":"2025092904570304300_bib42","doi-asserted-by":"publisher","first-page":"101583","DOI":"10.1016\/j.diabet.2024.101583","article-title":"Perirenal fat and chronic kidney disease in type 2 diabetes: the mediation role of afferent arteriolar resistance","volume":"50","author":"Chen","year":"2024","journal-title":"Diabetes Metab"},{"key":"2025092904570304300_bib43","doi-asserted-by":"publisher","first-page":"617","DOI":"10.3390\/metabo12070617","article-title":"Renal sinus fat is expanded in patients with obesity and\/or hypertension and reduced by bariatric surgery associated with hypertension remission","volume":"12","author":"Moritz","year":"2022","journal-title":"Metabolites"},{"key":"2025092904570304300_bib44","doi-asserted-by":"publisher","first-page":"658913","DOI":"10.1155\/2014\/658913","article-title":"New insight into adiponectin role in obesity and obesity-related diseases","volume":"2014","author":"Nigro","year":"2014","journal-title":"Biomed Res Int"},{"key":"2025092904570304300_bib45","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1111\/dom.12376","article-title":"Attenuated improvements in adiponectin and fat loss characterize type 2 diabetes non-remission status after bariatric surgery","volume":"16","author":"Malin","year":"2014","journal-title":"Diabetes Obes Metab"},{"key":"2025092904570304300_bib46","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1172\/jci32691","article-title":"Adiponectin regulates albuminuria and podocyte function in mice","volume":"118","author":"Sharma","year":"2008","journal-title":"J Clin Invest"},{"key":"2025092904570304300_bib47","doi-asserted-by":"publisher","first-page":"3055","DOI":"10.1210\/jc.2003-031403","article-title":"Glucagon-like peptide 1 induces natriuresis in healthy subjects and in insulin-resistant obese men","volume":"89","author":"Gutzwiller","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"2025092904570304300_bib48","doi-asserted-by":"publisher","first-page":"F231","DOI":"10.1152\/ajprenal.00432.2018","article-title":"Renal tubular effects of prolonged therapy with the GLP-1 receptor agonist lixisenatide in patients with type 2 diabetes mellitus","volume":"316","author":"Tonneijck","year":"2019","journal-title":"Am J Physiol Renal Physiol"},{"key":"2025092904570304300_bib49","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1007\/s00125-016-3938-z","article-title":"Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients: a randomised, double-blind, placebo-controlled trial","volume":"59","author":"Tonneijck","year":"2016","journal-title":"Diabetologia"},{"issue":"Suppl 1","key":"2025092904570304300_bib50","doi-asserted-by":"publisher","first-page":"2s20","DOI":"10.1016\/s1262-3636(17)30069-1","article-title":"The potential and pitfalls of GLP-1 receptor agonists for renal protection in type 2 diabetes","volume":"43","author":"Thomas","year":"2017","journal-title":"Diabetes Metab"},{"key":"2025092904570304300_bib51","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.kint.2023.09.029","article-title":"Glucagon-like peptide-1 receptor signaling modifies the extent of diabetic kidney disease through dampening the receptor for advanced glycation end products-induced inflammation","volume":"105","author":"Sourris","year":"2024","journal-title":"Kidney Int"},{"key":"2025092904570304300_bib52","doi-asserted-by":"publisher","first-page":"757228","DOI":"10.3389\/fendo.2021.757228","article-title":"Medications activating tubular fatty acid oxidation enhance the protective effects of roux-en-Y gastric bypass surgery in a rat model of early diabetic kidney disease","volume":"12","author":"Martin","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2025092904570304300_bib53","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1042\/cs20220205","article-title":"Dietary restriction and medical therapy drives PPAR\u03b1-regulated improvements in early diabetic kidney disease in male rats","volume":"136","author":"Martin","year":"2022","journal-title":"Clin Sci (Lond)"},{"key":"2025092904570304300_bib54","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.molmet.2018.09.009","article-title":"LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: from discovery to clinical proof of concept","volume":"18","author":"Coskun","year":"2018","journal-title":"Mol Metab"},{"key":"2025092904570304300_bib55","doi-asserted-by":"publisher","first-page":"170749","DOI":"10.1016\/j.peptides.2022.170749","article-title":"GLP-1 and GIP receptor signaling in beta cells\u2014a review of receptor interactions and co-stimulation","volume":"151","author":"Mayendraraj","year":"2022","journal-title":"Peptides"},{"key":"2025092904570304300_bib56","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.tem.2020.02.006","article-title":"How may GIP enhance the therapeutic efficacy of GLP-1?","volume":"31","author":"Samms","year":"2020","journal-title":"Trends Endocrinol Metab"},{"key":"2025092904570304300_bib57","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/S2213-8587(22)00243-1","article-title":"Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: post-hoc analysis of an open-label, randomised, phase 3 trial","volume":"10","author":"Heerspink","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025092904570304300_bib58","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.2337\/dc20-2151","article-title":"Effects of cotadutide on metabolic and hepatic parameters in adults with overweight or obesity and type 2 diabetes: a 54-week randomized phase 2b study","volume":"44","author":"Nahra","year":"2021","journal-title":"Diabetes Care"},{"key":"2025092904570304300_bib59","doi-asserted-by":"publisher","first-page":"160","DOI":"10.2337\/dc23-1287","article-title":"Efficacy and safety of mazdutide in Chinese patients with type 2 diabetes: a randomized, double-blind, placebo-controlled phase 2 trial","volume":"47","author":"Zhang","year":"2024","journal-title":"Diabetes Care"},{"key":"2025092904570304300_bib60","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1007\/s00125-023-06053-9","article-title":"Dose-response effects on HbA1c and bodyweight reduction of survodutide, a dual glucagon\/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial","volume":"67","author":"Bl\u00fcher","year":"2024","journal-title":"Diabetologia"},{"key":"2025092904570304300_bib61","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1038\/s41591-024-03018-2","article-title":"Triple hormone receptor agonist retatrutide for metabolic dysfunction-associated steatotic liver disease: a randomized phase 2a trial","volume":"30","author":"Sanyal","year":"2024","journal-title":"Nat Med"},{"key":"2025092904570304300_bib62","doi-asserted-by":"publisher","first-page":"E747","DOI":"10.1152\/ajpendo.00374.2023","article-title":"Incretin and glucagon receptor polypharmacology in chronic kidney disease","volume":"326","author":"McFarlin","year":"2024","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2025092904570304300_bib63","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1111\/dom.14712","article-title":"Efficacy and safety of cotadutide, a dual glucagon-like peptide-1 and glucagon receptor agonist, in a randomized phase 2a study of patients with type 2 diabetes and chronic kidney disease","volume":"24","author":"Parker","year":"2022","journal-title":"Diabetes Obes Metab"},{"key":"2025092904570304300_bib64","article-title":"A study of retatrutide (LY3437943) on renal function in participants with overweight or obesity and chronic kidney disease with or without type 2 diabetes","author":"Eli Lilly and Company"},{"key":"2025092904570304300_bib65","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1016\/s0140-6736(23)01163-7","article-title":"Efficacy and safety of co-administered once-weekly cagrilintide 2.4\u00a0mg with once-weekly semaglutide 2.4\u00a0mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial","volume":"402","author":"Frias","year":"2023","journal-title":"Lancet"},{"issue":"Suppl 1","key":"2025092904570304300_bib66","doi-asserted-by":"publisher","first-page":"92","DOI":"10.2337\/db23-92-LB","article-title":"92-LB: safety, tolerability, and clinical effects of ZP8396, a novel long-acting amylin analog\u2014a single ascending dose trial","volume":"72","author":"Olsen","year":"2023","journal-title":"Diabetes"},{"key":"2025092904570304300_bib67","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1089\/genedge.6.01.036","article-title":"StockWatch: challengers take aim at Lilly, Novo Nordisk","volume":"6","author":"Philippidis","year":"2024","journal-title":"GEN Edge"},{"key":"2025092904570304300_bib68","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1053\/j.ajkd.2023.04.009","article-title":"Blockbuster medications for obesity: a primer for nephrologists","volume":"82","author":"Zeitler","year":"2023","journal-title":"Am J Kidney Dis"},{"key":"2025092904570304300_bib69","doi-asserted-by":"publisher","first-page":"126","DOI":"10.2337\/dc22-0659","article-title":"Antihyperglycemic medication use among U.S. adults with hemodialysis-dependent kidney disease and comorbid diabetes","volume":"45","author":"Klein","year":"2022","journal-title":"Diabetes Care"},{"key":"2025092904570304300_bib70","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1001\/jama.2024.1017","article-title":"Could GLP-1 receptor agonists like semaglutide treat addiction, Alzheimer disease, and other conditions?","volume":"331","author":"Rubin","year":"2024","journal-title":"JAMA"},{"key":"2025092904570304300_bib71","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1053\/j.ackd.2014.03.003","article-title":"Cardiovascular complications of diabetic kidney disease","volume":"21","author":"P\u00e1lsson","year":"2014","journal-title":"Adv Chronic Kidney Dis"},{"key":"2025092904570304300_bib72","doi-asserted-by":"publisher","first-page":"2959","DOI":"10.1093\/eurheartj\/ehn387","article-title":"Adipose tissue dysfunction in obesity, diabetes, and vascular diseases","volume":"29","author":"Hajer","year":"2008","journal-title":"Eur Heart J"},{"key":"2025092904570304300_bib73","doi-asserted-by":"publisher","first-page":"F473","DOI":"10.1152\/ajprenal.00503.2013","article-title":"The physical basis of renal fibrosis: effects of altered hydrodynamic forces on kidney homeostasis","volume":"306","author":"Grabias","year":"2014","journal-title":"Am J Physiol Renal Physiol"},{"key":"2025092904570304300_bib74","doi-asserted-by":"publisher","first-page":"418","DOI":"10.3390\/ph17040418","article-title":"Finerenone: from the mechanism of action to clinical use in kidney disease","volume":"17","author":"Piko","year":"2024","journal-title":"Pharmaceuticals"},{"key":"2025092904570304300_bib75","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1053\/j.ajkd.2015.10.011","article-title":"Renin-angiotensin system inhibitors and kidney and cardiovascular outcomes in patients with CKD: a Bayesian network meta-analysis of randomized clinical trials","volume":"67","author":"Xie","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"2025092904570304300_bib76","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.1093\/ndt\/16.9.1790","article-title":"Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis","volume":"16","author":"Praga","year":"2001","journal-title":"Nephrol Dial Transplant"},{"key":"2025092904570304300_bib77","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1681\/asn.2010090969","article-title":"ACE inhibition is renoprotective among obese patients with proteinuria","volume":"22","author":"Mallamaci","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"2025092904570304300_bib78","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1159\/000446862","article-title":"Obesity, renin-angiotensin system blockade and risk of adverse renal outcomes: a population-based cohort study","volume":"43","author":"Cohen","year":"2016","journal-title":"Am J Nephrol"},{"key":"2025092904570304300_bib79","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/s0140-6736(08)61236-2","article-title":"Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial","volume":"372","author":"Mann","year":"2008","journal-title":"Lancet"},{"key":"2025092904570304300_bib80","doi-asserted-by":"publisher","first-page":"1892","DOI":"10.1056\/NEJMoa1303154","article-title":"Combined angiotensin inhibition for the treatment of diabetic nephropathy","volume":"369","author":"Fried","year":"2013","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib81","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1016\/j.ekir.2022.04.094","article-title":"Prescribing SGLT2 inhibitors in patients with CKD: expanding indications and practical considerations","volume":"7","author":"Yau","year":"2022","journal-title":"Kidney Int Rep"},{"key":"2025092904570304300_bib82","doi-asserted-by":"publisher","first-page":"sfae015","DOI":"10.1093\/ckj\/sfae015","article-title":"The risk of CKD progression remains high in patients treated with ACE inhibitors and ARBs, MRAs and SGLT2 inhibitors. Have we already achieved the therapeutic ceiling in CKD? (The CON part)","volume":"17","author":"Trillini","year":"2024","journal-title":"Clin Kidney J"},{"key":"2025092904570304300_bib83","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s40265-019-1057-0","article-title":"Emerging role of SGLT-2 inhibitors for the treatment of obesity","volume":"79","author":"Pereira","year":"2019","journal-title":"Drugs"},{"key":"2025092904570304300_bib84","doi-asserted-by":"publisher","first-page":"100679","DOI":"10.1016\/j.ajpc.2024.100679","article-title":"Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: a meta-analysis of randomized placebo-controlled trials","volume":"18","author":"Rivera","year":"2024","journal-title":"Am J Prev Cardiol"},{"key":"2025092904570304300_bib85","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1111\/dom.12982","article-title":"Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor","volume":"19","author":"DeFronzo","year":"2017","journal-title":"Diabetes Obes Metab"},{"key":"2025092904570304300_bib86","doi-asserted-by":"publisher","first-page":"2849","DOI":"10.1038\/s41591-024-03133-0","article-title":"Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial","volume":"30","author":"Mann","year":"2024","journal-title":"Nat Med"},{"key":"2025092904570304300_bib87","doi-asserted-by":"publisher","first-page":"e009992","DOI":"10.1161\/jaha.118.009992","article-title":"Use of antihypertensive agents and association with risk of adverse outcomes in chronic kidney disease: focus on angiotensin-converting enzyme inhibitors and angiotensin receptor blockers","volume":"7","author":"Ku","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2025092904570304300_bib88","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1053\/j.ajkd.2018.06.010","article-title":"Use of renin-angiotensin system blockade in advanced CKD: an NKF-KDOQI controversies report","volume":"72","author":"Weir","year":"2018","journal-title":"Am J Kidney Dis"},{"key":"2025092904570304300_bib89","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1681\/asn.0000000000000477","article-title":"Sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist discontinuation in patients with CKD","volume":"36","author":"Gregg","year":"2025","journal-title":"J Am Soc Nephrol"},{"key":"2025092904570304300_bib90","doi-asserted-by":"publisher","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib91","doi-asserted-by":"publisher","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events with finerenone in kidney disease and type 2 diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N Engl J Med"},{"key":"2025092904570304300_bib92","doi-asserted-by":"publisher","first-page":"2989","DOI":"10.1111\/dom.15197","article-title":"The impact of obesity on cardiovascular and kidney outcomes in patients with chronic kidney disease and type 2 diabetes treated with finerenone: post hoc analysis of the FIDELITY study","volume":"25","author":"Rossing","year":"2023","journal-title":"Diabetes Obes Metab"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfaf069\/63168224\/gfaf069.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/40\/10\/1977\/63168224\/gfaf069.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/40\/10\/1977\/63168224\/gfaf069.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T08:57:07Z","timestamp":1759136227000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/40\/10\/1977\/8129710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":92,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,5,13]]},"published-print":{"date-parts":[[2025,9,29]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfaf069","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,5,13]]}}}