Glucagon-Like Peptide-1 Receptor Agonist Use in People Living with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Narrative Review of the Key Evidence with Practical Considerations.

Type 2 diabetes mellitus (T2DM) is a common disorder characterized by insulin resistance and dysfunction of insulin-producing beta cells of the pancreas. People living with T2DM have an increased risk of developing complications, including chronic kidney disease (CKD), which itself is associated with increased mortality. Both the American Diabetes Association and Kidney Disease Improving Global Outcomes organization provide updated pharmacological recommendations for treating T2DM in people with CKD that include the use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) or glucagon-like peptide-1 receptor agonists (GLP-1 RAs). GLP-1 RAs are effective and safe treatments for controlling blood sugar levels and reducing body weight, and evidence from large clinical trials also suggests that GLP-1 RAs may be renoprotective. Despite the benefits of GLP-1 RAs, they are not commonly prescribed in people living with T2DM and CKD. Healthcare practitioners need to be aware of the most recent information so that they can make informed decisions when selecting treatment options. The objective of this review is to summarize the main renal outcomes from clinical studies while providing practical guidance on the use of GLP-1 RAs.