{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:39:00Z","timestamp":1792471140858,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obesity and type 2 diabetes mellitus (T2DM) accelerate chronic kidney disease (CKD) progression. Tirzepatide, a dual glucagon\u2010like peptide\u20101 (GLP\u20101) and glucose\u2010dependent insulinotropic polypeptide (GIP) receptor agonist, has demonstrated metabolic and potential renoprotective benefits in clinical trials. There have been limited reports of the implications of prescribing tirzepatide in a real\u2010world cohort of patients with advanced CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study includes a multi\u2010ethnic cohort of 62 adults with CKD stages 1\u20135 who initiated tirzepatide indicated for T2DM with concurrent obesity in a general nephrology clinic between June 2024 and October 2025. Patients were followed for a median of 21.4\u2009weeks. Clinical outcomes including weight, glycated haemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), urinary albumin\u2010to\u2010creatinine ratio (uACR), blood pressure, lipid profile and insulin requirements were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Tirzepatide significantly reduced median weight (103\u2013100\u2009kg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), HbA1c (63 [7.9%] to 54 [7.1%] mmol\/mol;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and uACR (111\u201344\u2009mg\/mmol;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), while eGFR remained stable. Significant improvements were also observed in triglycerides, total cholesterol, LDL cholesterol and total daily insulin dose. Gastrointestinal symptoms and decreased serum bicarbonate were the most common adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real\u2010world, multi\u2010ethnic cohort, including patients with advanced CKD, tirzepatide was associated with clinically meaningful improvements in weight, glycaemic control, albuminuria, lipid profile and insulin requirements without adversely affecting kidney function. The introduction of tirzepatide to patients with CKD should be guided by a multidisciplinary team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70500","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:54:09Z","timestamp":1792468449000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010world observational study evaluating metabolic and kidney outcomes in patients living with chronic kidney disease and type 2 diabetes mellitus with obesity prescribed tirzepatide"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5163-2441","authenticated-orcid":false,"given":"Jack E.","family":"Carruthers","sequence":"first","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi Yan","family":"Ooi","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Goodall","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Reed","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachna","family":"Bedi","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"McGrath","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Willicombe","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"},{"name":"Department of Immunology and Inflammation, Faculty of Medicine Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parizad","family":"Avari","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"},{"name":"Department of Immunology and Inflammation, Faculty of Medicine Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8732-4088","authenticated-orcid":false,"given":"Andrew H.","family":"Frankel","sequence":"additional","affiliation":[{"name":"West London Renal and Transplant Centre Imperial College Healthcare NHS Trust  London UK"},{"name":"Department of Immunology and Inflammation, Faculty of Medicine Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1111\/jdi.13355","article-title":"Changing epidemiology of chronic kidney disease as a result of type 2 diabetes mellitus from 1990 to 2017: estimates from global burden of disease 2017","volume":"12","author":"Li H","year":"2021","journal-title":"J Diabetes Investig"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1038\/ki.2010.531","article-title":"Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. 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