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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.
Chronic kidney disease (CKD) is a leading cause of premature death globally and is closely linked with type 2 diabetes (T2D) and obesity. While both sodium-glucose co-transporter protein 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown kidney benefit and are recommended by major guidelines in this population, there remains a lack of clarity on their foundational versus adjunctive role. This systematic literature review (SLR) aimed to identify evidence on comparisons (direct or indirect), combinations, or sequencing of SGLT2is and GLP-1 RAs in populations or subgroups of adults with CKD and T2D with or without overweight/obesity.
Searches of MEDLINE, Embase, Evidence-Based Medicine Reviews and grey literature were performed in May 2025. Articles were screened against pre-specified eligibility criteria by two independent reviewers and study quality was assessed using published checklists. Kidney and composite kidney outcomes were prioritized; additional safety, cardiovascular, HbA1c, and weight endpoints were also extracted.
A total of 922 records were identified through electronic database searches, with an additional 117 publications identified from hand searches. Overall, 48 publications were included, reporting on 38 unique studies: 11 meta-analyses (MAs) and 27 primary publications. Findings from MAs consistently favored SGLT2is over GLP-1 RAs for composite renal outcomes (effect estimate 0.73–0.89) (Figure). Primary research studies showed no clear direction of benefit for SGLT2is versus GLP-1 RAs for change in estimated glomerular filtration rate (eGFR) or albuminuria from baseline, or eGFR decline. However, where kidney disease progression was reported as an endpoint, results favored SGLT2is over GLP-1 RAs. Combination therapy with SGLT2i and GLP-1 RA showed signs of improvement in kidney outcomes (e.g. slower eGFR decline, greater reduction in albuminuria) compared with monotherapy. Only one study (RECAP) assessed treatment sequencing showing no significant difference in kidney outcomes based on order of initiation of SGLT2is versus GLP-1 RAs as part of combination therapy. MAs and primary studies consistently favored SGLT2is over GLP-1 RAs for prevention of hospitalization for heart failure. A small number of primary studies reported on specific cardiovascular, weight change, body-mass index, and HbA1c outcomes, but their findings were not consistent with the evidence base from non-comparative placebo-controlled trials that have demonstrated benefits of GLP-1 RAs for atherosclerotic cardiovascular disease and metabolic outcomes.
In the absence of head-to-head trials, the evidence identified supports the use of SGLT2is as a foundational therapy in adults with CKD with T2D and overweight/obesity, and the positioning of GLP-1 RAs as a complementary option for patients with elevated kidney, metabolic and/or cardiovascular risk. However, uncertainties remain around optimal sequencing, combination use, and identification of patient subgroups most likely to benefit from each therapy. These gaps underscore the need for real-world data and expert consensus, to inform recommendations on sequencing and positioning of SGLT2is and GLP-1 RAs in CKD management.
Acknowledgements: Funding: AstraZeneca; medical writing: Costello Medical.
