Glucagon-like peptide-1 receptor agonists and its possible nephroprotective role: a systematic review

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are commonly used to manage type 2 diabetes (T2DM), offering benefits not only for blood sugar control but also potentially for kidney health. While some studies have looked at kidney function, no review has specifically focused on how these medications impact kidney health in people with diabetes. Evidence acquisition: We conducted a review of existing studies following established guidelines. We searched databases like PubMed, Embase, Web of Science, and the Cochrane Library for studies that examined kidney outcomes - such as estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) - in T2DM patients treated with GLP-1RAs. We also assessed the quality of these studies using well-known bias risk tools. Evidence synthesis: We included 13 studies, including clinical trials and observational research. Overall, the findings suggest that GLP-1RAs may help slow the decline in kidney function, reduce proteinuria and improve other kidney health markers in people with T2DM. However, the results weren't consistent - some studies showed clear benefits, while others found little to no effect. Conclusions: This review highlights the potential for GLP-1RAs to protect kidney function in people with type 2 diabetes. Although the evidence is encouraging, the differences between studies suggest the need for more large-scale, well-designed trials to confirm these effects and help guide treatment decisions.