GLP-1 Receptor Agonists Significantly Reduce MACE Risk Across the CKD Spectrum, Yet Prescription Rates Remain Suboptimal

Introduction: The Shifting Paradigm in Cardio-Renal Care

Chronic kidney disease (CKD) is no longer viewed merely as a decline in filtration, but as a potent accelerator of cardiovascular morbidity and mortality. For decades, the therapeutic armamentarium for patients with CKD and type 2 diabetes (T2DM) was limited. However, the emergence of glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose co-transporter 2 inhibitors (SGLT2is) has revolutionized the field. While the cardiovascular benefits of GLP1-RAs are well-established in the general T2DM population, their efficacy across the full spectrum of CKD severity—particularly in real-world settings—and the consistency of their uptake in clinical practice have remained areas of active investigation.

Two landmark studies recently published in the American Journal of Kidney Disease and Diabetes, Obesity and Metabolism provide a dual perspective on this issue: one confirming the profound clinical benefits of GLP1-RAs in CKD populations, and the other highlighting a significant implementation gap in primary care.