Cardiovascular outcome trials often report a degree of heterogeneity in renal outcomes in secondary analyses, complicating comparisons between medications.

This article outlines the mechanisms by which diabetes medications influence renal function as well as the renal outcomes reported by cardiovascular and renal outcome trials of newer diabetes therapies to date.

Trial data indicate that SGLT-2 inhibitors, DPP-4 inhibitors and GLP-1 analogues all reduce the rate of decline in albuminuria in people with diabetes and chronic kidney disease, and that SGLT-2 inhibitors also reduce the rate of glomerular filtration rate (GFR) decline in this cohort.

Further work should focus on reporting consistent renal outcome measures in cardiovascular and renal outcome trials to facilitate simpler comparisons between drugs and drug classes.