SGLT2 inhibitors demonstrate superior renal outcomes in T2D. The findings were presented at the European Association for the Study of Diabetes (EASD) 2025.  A multicenter retrospective study compared SGLT2 inhibitors and GLP-1 receptor agonists on kidney function, eGFR decline, and albuminuria in patients with T2D.
Patients had a mean age of 61 years, diabetes duration of 10 years, baseline HbA1c of 8.0%, and BMI of 33 kg/m². CKD was present in 23% at baseline. SGLT2i included dapagliflozin, empagliflozin, canagliflozin, and ertugliflozin, while GLP-1RA included dulaglutide, liraglutide, exenatide, semaglutide, and lixisenatide.

Over a median follow-up of 2.2 years, SGLT2i slowed eGFR decline compared to GLP-1RA by 1.19 ml/min/1.73 m² and reduced the rate of creatinine doubling (HR 0.64, p=0.047). Albuminuria changes were similar between groups. SGLT2i also yielded modest benefits in body weight (-1.3 kg) and systolic blood pressure (-1.1 mmHg). Results were consistent in patients without baseline CKD, indicating benefits even for primary prevention.

These findings demonstrate the potential of SGLT2 inhibitors to preserve kidney function and reduce risk of CKD progression in T2D, even in patients without baseline renal impairment.