Table 2 Effects of diabetic drugs on gut microbiota and renal outcomes

Agent	Drug	Effect on gut microbiota	Effect on renal outcome	Reference
		Phylum level	Family level	Genus/species level
GLP-1 receptor agonists	Exenatide	Unknown	Unknown	Unknown	Reduce albuminuria and pathological renal injury	121,122
Liraglutide	Bacteroides↑, Verrucomicrobia↑, Proteobacteria↓, Actinobacteria↓	Rikenellaceae↑, S24-7↑, Erysipelotrichaceae↑, Lachnospiraceae↓, Peptostreptococcacea↓	Akkermansia↑, Romboutsia↑, Anaerotruncus↓, Klebsiella↓, Lachnospiraceae_UCG-001↓, Lachnospiraceae_NK4A136_group↓, Ruminiclostridium↓, Desulfovibrio ↓	Reduce the incidence of nephropathy and macroalbuminuria	125,127,129,130
Dulaglutide	Bacteroides↑, Firmicutes↓	Unknown	Aerococcus↑, Akkermansia↑, Bacteroides↑, Barnesiella↑, Ruminococcus↑, Oscillibacter↑, Coprobacillus↓	Lower the incidence in new-onset large albuminuria and sustained decline of eGFR	131,133
Lixisenatide	Unknown	Unknown	Unknown	Improve UACR	134,135
DPP-4 inhibitors	Linagliptin	Bacteroides↑, Actinobacteria↓, Proteobacteria↓	Unknown	Unknown	Reduce proteinuria and improve renal injury	140,142,143
Alogliptin	Unknown	Unknown	Unknown	Improve UACR and maintain eGFR	144
Saxagliptin	Firmicutes↑, Bacteroides ↓	Erysipelotrichaceae↑, Bacteroidaceae ↓	Lactobacillus↑, Allobaculum↑, Turicibacter↑, Prevotella ↓	Improve UACR	147,148
Sitagliptin	Bacteroides↑, Proteobacteria↑, Actinobacteria↑, Firmicutes↓, Tenericutes↓	Ruminococcaceae↑	Roseburia↑, Bifidobacterium↑, Blautia ↓	Reduce urinary albumin levels	150,151
SGLT-2 intibitors	Canagliflozin	Actinobacteria↓, TM-7↓	Unknown	Alistipes↑, Alloprevotella↑, Olsenella↑, Oscillospira↓, Bifidobacterium↓, Helicobacter↓, Mucispirillum↓	Reduce plasma uremic toxins and lower UACR	155,157,158
Dapagliflozin	Firmicutes↑, Proteobacteria,↑ Bacteroides ↓, Actinobacteria↓	Desulfovibrionaceae↑, Lactobacillaceae ↓	Oscillospira↓, Mucispirillum↓, Barnesiella↓	Prevent progression of kidney disease	160−163
Empagliflozin	Bacteroides↑, Firmicutes↓	Unknown	Bacteroides↑, Bifidobacterium↑, Parabacteroides↑	Reduce the risk of nephropathy, proteinuria and serum creatinine	133,164,165
Ertugliflozin	Unknown	Unknown	Unknown	Reduce the risk of renal composite endpoint and preserve eGFR and UACR	167,168