YES! SGLT2i is better than GLP-1RA for preservation of renal function in Type 2 Diabetes.
In individuals with type 2 diabetes, treatment with SGLT2i was associated with better preservation of renal function compared with GLP-1RA, as evidenced by slower decline in eGFR. These findings reinforce SGLT2i as preferred agents for renal protection in this patient population.
Remarkable evidence of protection against adverse kidney outcomes has been consistently shown for SGLT2 inhibitors. GLP-1 Receptor Agonists appears to exert protection mainly against new onset macroalbuminuria. Apparently, there is no trial directly comparing renal outcomes during therapy with SGLT2i or GLP-1RA. But then the question arises if there is any difference in renal outcomes of cohorts of patients with Type 2 Diabetes receiving SGLT2i or GLP-1RA under routine care?
Among 5701 matched individuals per group observed for a median of 2.1 years, eGFR remained higher in SGLT2i groups as compared with GLP-1RA group. No differences were detected in albuminuria change. Also, the SGLT2i reduced eGFR decline better than GLP-1RA in participants without chronic kidney disease at baseline. These findings will reinforce the use of SGLT2i as preferred agents for renal protection in people with Type 2 Diabetes and lower renal risk.
Main article link: https://link.springer.com/article/10.1007/s00125-024-06251-z
Reference:
- Wanner C, Inzucchi SE, Lachin JM et al (2016) Empagliflozin and progression of kidney disease in type 2 diabetes. N Engl J Med 375(4):323–334. https://doi.org/10.1056/NEJMoa1515920
- Fioretto P, Pontremoli R (2022) Expanding the therapy options for diabetic kidney disease. Nat Rev Nephrol 18(2):78–79. https://doi.org/10.1038/s41581-021-00522-3
- Perkovic V, Tuttle KR, Rossing P et al (2024) Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes. N Engl J Med 391:109–121.