Table 1.

Clinical effects of GLP-1RAs on DKD.

Trial	Agents, Follow-up Duration	Subjects	Renal Outcomes	Results
LEADER (n=9,340)	Liraglutide (1.8 mg) vs. placebo, 3.84 years	T2D with high CV risk	New-onset macroalbuminuria, doubling of the serum creatinine level, ESRD, renal death	HR 0.78 (95% CI: 0.67-0.92)
SUSTAIN-6 (n=3,297)	Semaglutide (0.5 mg, 1.0 mg) vs. placebo, 104 weeks	T2D Age >50 with established CVD or CKD stage 3-5 Age >60 with CV risk factors	New or worsening of nephropathy (persistent macroalbuminuria, doubling of the serum creatinine level and CCr < 45 mL/min/1.73 m2, RRT)	HR 0.64 (95% CI: 0.46-0.88)
REWIND (n=9,901)	Dulaglutide (1.5 mg) vs. placebo, 5.4 years	T2D with a previous CV event or CV risk factors	New onset of macroalbuminuria, sustained eGFR decline (≥30%) or RRT	HR 0.85 (95% CI: 0.77-0.93)
AWARD-7 (n=576)	Dulaglutide (0.75 mg, 1.5 mg) vs. placebo, 52 weeks	T2D with moderate to severe CKD (stage 3-4)	Changes in eGFR decline and UACR from baseline	eGFR decline: -1.1 (1.5 mg), -1.5 (0.75 mg), -2.9 (glargine) UACR: no significant differences among groups
ELIXA (n=6068)	Lixisenatide (10-20 μg) vs. placebo, 108 weeks	T2D with recent acute coronary syndrome	Percent change in UACR and eGFR from baseline	eGFR decline: no significant differences among groups UACR: -1.69% (95% CI: -11.69% to 8.30%) in patients with normoalbuminuria, -21.10% (95% CI: -42.25% to 0.04%) in patients with microalbuminuria, -39.18% (95% CI: -68.53% to -9.84%) in patients with macroalbuminuria

These effects are mainly driven by the reduction of albuminuria.