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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Diabetic kidney disease (DKD) remains a leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, emphasizing the need for therapies that can slow renal decline. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated cardiovascular and metabolic benefits, with growing evidence suggesting direct renoprotective potential. However, the magnitude and consistency of kidney benefits across trials remain uncertain, particularly with the recent addition of data from the FLOW trial. This meta-analysis aimed to evaluate the effect of GLP-1 RAs on adverse kidney outcomes in patients with type 2 diabetes (T2D), incorporating the FLOW trial to provide an updated synthesis of current evidence.
A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Electronic databases, including PubMed, Embase, and the Cochrane Central Register of Controlled Trials, were searched from inception to December 2024 for randomized controlled trials (RCTs) comparing GLP-1 RAs with placebo in adults (≥18 years) with T2D reporting kidney outcomes. The primary composite kidney outcome comprised new-onset or sustained macroalbuminuria, sustained eGFR decline, progression to ESRD, or kidney-related death. Data were pooled using a random-effects model to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic and Chi² test. Statistical analyses were conducted using Review Manager (RevMan, version 5.4).
Six large-scale RCTs involving 46,891 participants were analyzed: ELIXA, LEADER, SUSTAIN-6, EXSCEL, REWIND, and FLOW. GLP-1 RAs significantly reduced the risk of adverse kidney outcomes by 18% versus placebo (OR 0.82; 95% CI 0.77–0.87; Z = 6.12; p < 0.00001), with low heterogeneity (I² = 17%; Chi² = 6.04, df = 5, p = 0.30). The overall effect was robust and consistent across varying study durations (2–5.4 years), patient populations, and baseline kidney function, including those with advanced CKD in FLOW. Funnel plot analysis showed no evidence of publication bias. Mechanistically, GLP-1 RAs may exert renoprotection through improved glycemic control, blood pressure reduction, and anti-inflammatory and hemodynamic pathways that mitigate glomerular hyperfiltration.
This meta-analysis highlights the renoprotective benefit of GLP-1 RAs in patients with T2D, demonstrating their capacity to delay DKD progression. These findings support incorporating GLP-1 RAs into therapeutic strategies for DKD and emphasize the need for studies exploring agent-specific differences, long-term renal outcomes, and applicability in non-diabetic CKD.
