Santos GL, dos Santos CF, Rocha GR, Calmon MS, Lemos FF, Silva LG, Luz MS, Pinheiro SL, Botelho AC, de Melo FF. Beyond glycemic control: Roles for sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in diabetic kidney disease. World J Diabetes 2025; 16(6): 104706 [DOI: 10.4239/wjd.v16.i6.104706]
Corresponding Author of This Article
Fabrício F de Melo, PhD, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremeloufba@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jun 15, 2025; 16(6): 104706 Published online Jun 15, 2025. doi: 10.4239/wjd.v16.i6.104706
Beyond glycemic control: Roles for sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in diabetic kidney disease
Gabriel LC Santos, Clara FSM dos Santos, Gabriel R Rocha, Mariana S Calmon, Fabian FB Lemos, Luis GO Silva, Marcel S Luz, Samuel LR Pinheiro, Anelise CS Botelho, Fabrício F de Melo
Gabriel LC Santos, Clara FSM dos Santos, Gabriel R Rocha, Mariana S Calmon, Fabian FB Lemos, Luis GO Silva, Marcel S Luz, Samuel LR Pinheiro, Anelise CS Botelho, Fabrício F de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
Co-first authors: Gabriel LC Santos and Clara FSM dos Santos.
Author contributions: Santos GL and dos Santos CF contributed equally to the conception of the work, Tables and Figures preparation, interpretation of relevant literature, topic division, performance of literature research, manuscript revision and writing and share the first authorship; Lemos FF and Calmon MS contributed to conceptualizing the idea of the manuscript and in the research and writing processes; Rocha GR, Luz MS, Silva LG and Pinheiro SL contributed in the research and writing processes; Botelho AC is a board-certified nephrologist with expertise in the field of chronic kidney disease management and hemodialysis and provided clinical insights and supervised the writing of the written text; de Melo FF supervised the writing of the original draft and contributed to the conceptualization of the idea.
Supported by Industrial Technological Initiation Scholarship of National Council for Scientific and Technological Development, CNPq, Brazil, No. 0932204294929829 and No. 7414780530977345; the Scientific Initiation Scholarship Programme (PIBIC) of National Council for Scientific and Technological Development, CNPq, Brazil, No. 5763023359532159, No. 6472982965854452, and No. 7340128440641417; and the CNPq Research Productivity Fellow, No. 4357511882624145.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabrício F de Melo, PhD, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremeloufba@gmail.com
Received: December 31, 2024 Revised: March 4, 2025 Accepted: March 28, 2025 Published online: June 15, 2025 Processing time: 166 Days and 14.2 Hours
Abstract
The global prevalence of diabetes has surged in recent years, with diabetic kidney disease (DKD) emerging as a major complication. Traditional therapies have had limited success in slowing progression to end-stage kidney disease. However, novel therapies, particularly sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, which were initially developed for hyperglycemia management, have transformed the treatment of obesity, heart failure, cardiovascular disease, and more recently, DKD. SGLT2 inhibitors have consistently and significantly reduced cardiovascular events, albuminuria, and glomerular filtration rate, highlighting their efficacy across diverse clinical presentations for patients with kidney impairment. Although fewer studies have specifically investigated GLP-1 receptor agonists in patients with kidney disease, existing evidence underscores their potential to slow renal disease progression, reduce albuminuria, and improve clinically relevant outcomes. However, further research is needed to better identify patients most likely to benefit from treatment. Together, these therapies represent valuable advancements for DKD, offering significant reductions in morbidity and mortality and shifting the management of the disease by becoming essential pillars for the treatment of these patients.
Core Tip: Diabetes is the leading cause of chronic kidney disease. Until recently, treatment options for diabetes-associated renal impairment were limited until recently. Over the past decade, research in this field has expanded considerably, incorporating several new therapies with proven benefits in slowing kidney disease progression, especially sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. Understanding the state of research with these therapies and clinical recommendations for their use in the context of diabetic kidney disease is a crucial step in providing optimized treatment options for patients with this condition.
