Dual GIP/GLP-1 Receptor Agonists and Kidney Protection: Expanding Therapeutic Horizons in Nephrology

Authors:
Open Access
Publisher website
Google Scholar
Abstract
Dual GIP/GLP-1 receptor agonists have emerged as an innovative therapeutic class that combines metabolic and renal protection in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). This multicenter study, conducted in Mexico, Colombia, and Ecuador, evaluated the renal and metabolic effects of dual incretin therapy compared with GLP-1 receptor agonists and standard therapy (SGLT2 inhibitors plus RAAS blockade). A total of 1,150 adults with T2DM and CKD stages 1–4 were included. The dual GIP/GLP-1 group achieved the greatest improvement in kidney outcomes, with a 29% reduction in urinary albumin-to-creatinine ratio (UACR) and the smallest annual decline in estimated glomerular filtration rate (eGFR, −1.6 mL/min/1.73 m²), compared to GLP-1 monotherapy (−2.6) and standard therapy (−3.5). Additionally, participants receiving dual agonists showed superior metabolic control, including reductions in HbA1c (−17.9%), body mass index (−10.6%), and systolic blood pressure (−9.1 mmHg). Overall, 58.9% achieved composite kidney improvement and 76.3% avoided progression to a higher KDIGO risk category. These results align with international evidence from the SURPASS and FLOW trials, confirming that dual receptor activation offers synergistic mechanisms—anti-inflammatory, antifibrotic, and hemodynamic—that extend renal protection beyond glycemic control. The findings support incorporating dual GIP/GLP-1 receptor agonists into nephrology practice as a next-generation therapy capable of modifying the natural history of diabetic kidney disease and improving long-term clinical outcomes in diverse Latin American populations.

This publication has 14 references indexed in Scilit: