Abstract: SA-PO0432
Effect of Incretin Receptor Agonists with or Without SGLT2 Inhibitors on Cardiorenal Metabolic Outcomes in Patients with CKD and Obesity
Session Information
- CKM: Clinical - Epidemiology and Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Lodrigues, Abigail Brooke, UNC Health, Chapel Hill, North Carolina, United States
- Davis, Katherine P., UNC Health, Chapel Hill, North Carolina, United States
- Greene, Mackenzie, The University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, North Carolina, United States
- Perez, Alejandro Daniel, UNC Health, Chapel Hill, North Carolina, United States
- Russell, Alissa, UNC Health, Chapel Hill, North Carolina, United States
- Zeitler, Evan, UNC Health, Chapel Hill, North Carolina, United States
- Yang, Anita, UNC Health, Chapel Hill, North Carolina, United States
Background
Incretin receptor agonists and sodium-glucose cotransporter-2 inhibitors (SGLT2i) have limited real-world evidence evaluating their effects on cardiorenal metabolic outcomes. This study assessed these outcomes in patients with CKD treated with an incretin receptor agonist compared to those on combination therapy with SGLT2i.
Methods
Single-center, retrospective cohort including adults with CKD (eGFR 15–59 mL/min/1.73 m2 and/or UACR >200 mg/g) and obesity treated 1/1/2023-10/31/2024. Cohort 1 received incretin receptor agonist alone, Cohort 2 received incretin receptor agonist with SGLT2i. Primary outcome assessed the change in eGFR from baseline (prior to incretin receptor agonist) to12 months following therapy. Secondary outcomes included changes in UACR, BMI, blood pressure, and lipids.
Results
100 patients were included (Cohort 1: 41, Cohort 2: 59). Baseline characteristics were similar between cohorts: most had moderate-severe albuminuria, treated with subcutaneous semaglutide, though Cohort 2 had higher rates of T2DM compared to Cohort 1 (98.3% vs 63.4%). Within 12 months following incretin receptor agonist, eGFR decreased by 7.9% in Cohort 1 but increased by 2.6% in Cohort 2 (p=0.011). Both groups had substantial UACR reductions without between-group differences (-45.6% vs –29%). Other cardiometabolic changes were similar.
Conclusion
Despite UACR reductions in both cohorts without differences in metabolic variables, combination therapy with an incretin receptor agonist and SGLT2i was associated with preserved eGFR versus incretin receptor agonist alone. These findings support an additive benefit of combination therapy in patients with CKD and obesity.