{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:40:38Z","timestamp":1786372838569,"version":"build-2736575974"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"crossref","award":["DB-2020C2-20306"],"award-info":[{"award-number":["DB-2020C2-20306"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Maryland Institute for Health Computing"},{"DOI":"10.13039\/100024377","name":"Montgomery County Government","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100024377","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100019823","name":"University of Maryland, Baltimore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019823","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Maryland, College Park"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists were superior to dipeptidyl peptidase-4 inhibitor and sulfonylurea for preventing kidney complications in patients with type 2 diabetes at moderate cardiovascular disease risk.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Sodium-glucose cotransporter 2 inhibitor therapy compared favorably with glucagon-like peptide-1 receptor agonists for kidney disease outcomes.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>CKD is a serious diabetes-related complication. While guidelines recommend use of sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1RA) therapies to mitigate cardiorenal risk in high-risk patients, the benefit of early initiation of these agents relative to other commonly prescribed glucose-lowering agents in patients at lower baseline cardiovascular disease (CVD) risk remains less clear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study emulated an idealized target trial using claims data from OptumLabs data warehouse to test the comparative association of treatment with a dipeptidyl peptidase-4 inhibitor (DPP-4i), SGLT2i, GLP-1RA, or sulfonylurea (SU) on a primary kidney composite outcome of incident CKD stages 3\u20135, kidney failure, or need for KRT in patients with type 2 diabetes and moderate CVD risk. A secondary composite outcome included all components of the primary composite outcome plus death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 364,714 adults aged 21 years or older initiating treatment with a DPP-4i (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      =78,843), GLP-1RA (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      =42,049), SGLT2i (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      =45,466), or SU (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      =198,356) were identified. Relative to DPP-4i, SGLT2i (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.67 to 0.74;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and GLP-1RA (HR, 0.87; 95% CI, 0.83 to 0.92;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) treatment was superior for the primary composite outcome. Similarly, SGLT2i (HR, 0.69; 95% CI, 0.66 to 0.73) and GLP-1RA (HR, 0.86; 95% CI, 0.82 to 0.91) treatment was associated with risk reductions for the primary outcome relative to SU treatment. When comparing SGLT2i with GLP-1RA therapy, SGLT2is were superior for the primary composite outcome (HR, 0.81; 95% CI, 0.75 to 0.86;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Similar findings were observed for the secondary composite outcome across all comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SGLT2is and GLP-1RAs were superior to DPP-4is and SUs for preventing kidney complications in a type 2 diabetes population with moderate baseline CVD risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial registry name and registration number:<\/jats:title>\n                    <jats:p>NCT05214573.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000587","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T12:36:27Z","timestamp":1728390987000},"page":"206-217","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Kidney Outcomes with Glucagon-Like Peptide-1 Receptor Agonists, Sodium-Glucose Cotransporter 2 Inhibitors, Dipeptidyl Peptidase-4 Inhibitors, and Sulfonylureas in Type 2 Diabetes and Moderate Cardiovascular Risk"],"prefix":"10.2215","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4734-7402","authenticated-orcid":false,"given":"Joshua J.","family":"Neumiller","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy, Washington State University, Spokane, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3671-3622","authenticated-orcid":false,"given":"Jeph","family":"Herrin","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavya Sindhu","family":"Swarna","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota"},{"name":"OptumLabs, Eden Prairie, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric C.","family":"Polley","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9295-3225","authenticated-orcid":false,"given":"Rodolfo J.","family":"Galindo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo E.","family":"Umpierrez","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihong","family":"Deng","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota"},{"name":"OptumLabs, Eden Prairie, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9218-3320","authenticated-orcid":false,"given":"Joseph S.","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3664-127X","authenticated-orcid":false,"given":"Mindy M.","family":"Mickelson","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic Robert D. and Patricia E. 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