Purpose and Overview

The worldwide epidemiology and risks of diabetes and chronic kidney disease (CKD) will be described to set the stage for a discussion of treatment with glucagon-like peptide-1 (GLP-1) receptor agonists. The history of how GLP-1 receptor agonists were discovered to be heart and kidney protective will be reviewed, followed by the clinical evidence leading to the first large kidney disease outcomes trial of a GLP-1 receptor agonist. The FLOW trial testing semaglutide versus placebo in persons with type 2 diabetes and CKD will be discussed in detail including the primary kidney disease outcome as well as the cardiovascular and mortality outcomes. Data on CKD measures from the studies of GLP-1 receptor agonists in persons with overweight or obesity, with and without diabetes, will also be reviewed as a glimpse into future directions. The presentation will conclude with implications for clinical practice and a case study.