{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:09:23Z","timestamp":1792091363265,"version":"4.4.0"},"reference-count":141,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy of Timisoara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Diabetic kidney disease (DKD) remains a major cause of advanced chronic kidney disease (CKD) and cardiovascular (CV) mortality, despite optimization of renin\u2013angiotensin\u2013aldosterone system (RAAS) blockade and the use of sodium\u2013glucose cotransporter-2 inhibitors (SGLT2i). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are cardiometabolic agents with significant efficacy on glycemic control, body weight, blood pressure (BP), lipid profile, and systemic inflammation. In experimental studies, GLP-1 RAs showed direct renal effects by modulating natriuresis, intrarenal hemodynamics, oxidative stress, endothelial dysfunction, and tubular apoptosis. Randomized clinical trials and real-life analyses have demonstrated reductions in albuminuria and slowing of glomerular filtration rate (GFR) decline. The first study with a primary renal endpoint for semaglutide confirms its nephroprotective potential. This narrative review synthesizes the renal mechanisms involved. The clinical evidence for GLP-1 RA in DKD positions this class alongside SGLT2i and non-steroidal mineralocorticoid receptor antagonists (ns-MRAs) for the management of patients with type 2 diabetes mellitus (T2D), CKD, and very high cardiorenal risk.<\/jats:p>","DOI":"10.3390\/medicina62081509","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T16:48:08Z","timestamp":1785948488000},"page":"1509","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Renal Effects of Glucagon-like Peptide-1 Receptor Agonists in Diabetic Kidney Disease: A Narrative Review of Mechanisms and Clinical Evidence"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7904-6073","authenticated-orcid":false,"given":"Adina","family":"Braha","sequence":"first","affiliation":[{"name":"Department of Second Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, \u201cPius Br\u00eenzeu\u201d County Emergency Clinical University Hospital, 300723 Timisoara, Romania"},{"name":"Center for Molecular Research in Nephrology and Vascular Disease (MOL-NEPHRO-VASC), \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0993-6206","authenticated-orcid":false,"given":"Bogdan","family":"Timar","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, \u201cPius Br\u00eenzeu\u201d County Emergency Clinical University Hospital, 300723 Timisoara, Romania"},{"name":"Center for Molecular Research in Nephrology and Vascular Disease (MOL-NEPHRO-VASC), \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Sturza","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, \u201cPius Br\u00eenzeu\u201d County Emergency Clinical University Hospital, 300723 Timisoara, Romania"},{"name":"Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0792-9202","authenticated-orcid":false,"given":"Romulus","family":"Timar","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, \u201cPius Br\u00eenzeu\u201d County Emergency Clinical University Hospital, 300723 Timisoara, Romania"},{"name":"Center for Molecular Research in Nephrology and Vascular Disease (MOL-NEPHRO-VASC), \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref_1","unstructured":"(2026, February 01). 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