Chronic kidney disease (CKD) is a leading cause of morbidity in type 2 diabetes mellitus (T2DM). Renal risk remains high despite improvements in cardiovascular outcomes. A scoping review published in Diabetes Therapy evaluated kidney outcomes associated with glucagon-like peptide 1 (GLP-1)-based therapies. This included dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists across CKD stages and metabolic phenotypes.

The review followed the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The protocol was registered on the Open Science Framework (OSF). Searches of PubMed, Embase, and CENTRAL from inception to October 2025 identified 607 records. A total of 35 studies met the inclusion criteria. These included phase 2 to 4 randomized controlled trials (RCTs), post hoc RCT analyses, and comparative observational studies reporting kidney outcomes. Risk of bias and certainty were assessed using RoB 2, Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) frameworks.

Randomized evidence supported renal benefits for semaglutide, dulaglutide, and liraglutide. These agents reduced composite kidney outcomes and slowed decline in estimated glomerular filtration rate (eGFR). Tirzepatide reduced albuminuria and attenuated eGFR decline compared with insulin glargine. Efpeglenatide, cotadutide, exenatide, and lixisenatide showed class-consistent antiproteinuric effects. Observational data extended these findings to real-world settings and advanced CKD populations.

GLP-1-based therapies demonstrated consistent renoprotective effects across CKD stages and metabolic phenotypes. Effects were partly independent of glycemic and weight-related changes. Evidence was strongest for semaglutide and dulaglutide, with emerging data for tirzepatide and other incretin-based agents.