Kidney Week

Abstract: TH-PO1242

Kidney Outcomes Associated with Tirzepatide vs. GLP-1 Receptor Agonist Use in Patients with Type 2 Diabetes and CKD

Session Information

• Late-Breaking Research Posters
  October 22, 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

• Huang, Tzu-shan, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan

Tzu-shan Huang, MD

• Chang, Ho-Hsiang, Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

Ho-Hsiang Chang, MD

• Chao, Jo-Yen, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan

Jo-Yen Chao, MD, PhD

• Lin, Wei-Ren, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan

Wei-Ren Lin, MD

• Lin, Wei-hung, National Cheng Kung University Hospital, Tainan City, Taiwan

Wei-hung Lin, MD, PhD

Background

Tirzepatide improves glycemia and weight, but comparative kidney outcome data versus GLP-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) are limited.

Methods

We emulated a target trial using the TriNetX Global Collaborative Network. Adults with T2D and CKD who newly initiated tirzepatide or a GLP-1 RA during 2021-2024 were included. Patients with baseline kidney failure requiring dialysis or kidney transplantation were excluded. Tirzepatide and GLP-1 RA initiators were propensity-score matched 1:1 using demographics, comorbidities, medications, and laboratory measures. The primary outcome was a composite of stage 5 CKD, kidney failure, dialysis, or all-cause death. Secondary outcomes included kidney-specific events, all-cause mortality, and cardiovascular events. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

After matching, 8,785 patients were included in each group. Tirzepatide initiation was associated with lower risk of the primary composite outcome (HR, 0.64; 95% CI, 0.57-0.72), kidney-specific events (HR, 0.83; 95% CI, 0.71-0.96), all-cause mortality (HR, 0.50; 95% CI, 0.43-0.58), and cardiovascular events (HR, 0.91; 95% CI, 0.83-0.99). A 60-day landmark analysis yielded a similar association for the primary outcome (HR, 0.69; 95% CI, 0.61-0.78), and findings were generally consistent across prespecified subgroups.

Conclusion

Among patients with T2D and CKD, tirzepatide initiation was associated with lower observed risks of kidney, cardiovascular, and mortality outcomes than GLP-1 RA initiation. These findings support prospective evaluation of tirzepatide using kidney-specific endpoints in this high-risk population.

Acknowledgment

OpenAI ChatGPT (GPT-5.6 Sol; OpenAI, San Francisco, CA; September 2026) was used to assist with language editing and organization of the abstract. All authors reviewed and verified the final content and take full responsibility for its accuracy and integrity.

Funding

• Government Support - Non-U.S.