Not medical advice. A record of published research and our assessments of it. The limits

GLP-1 receptor agonists protect kidney function in people without diabetes.

Current status: ProbableEvidence strengthening · Kidney
Why: FLOW established kidney protection in type 2 diabetes with CKD. In SELECT (no diabetes, obesity + CVD) a composite kidney endpoint was reduced (HR 0.78) and eGFR decline was slower; a meta-analysis found effects consistent with the diabetes trials. Evidence in normal-weight people without CVD does not exist. Body-composition changes did not distort GFR estimates in the small SMART trial.
What would change it: A kidney-outcome trial in non-diabetic CKD without obesity.
Linked studies: 4 · 3 supports · 1 mixed
Last updated: Sep 13, 2026

The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.

01The evidence

The evidence, sorted by what it shows

Effects of GLP-1 receptor agonists on kidney and cardiovascular disease outcomes: a meta-analysis of randomised controlled trialsMeta-analysis · 2025 · Study tier 1 · Different population · Benefit
Meta-analysis of 11 RCTs: composite kidney outcome HR 0.82; SELECT consistent.
Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 DiabetesRandomized trial · 2024 · Study tier 1 · Different population · Benefit · Industry funded
FLOW: HR 0.76 for major kidney events in T2D+CKD; stopped early for efficacy (may overestimate).
Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trialRandomized trial · 2024 · Study tier 2 · Different population · Benefit · Industry funded
SELECT kidney analysis: HR 0.78 for composite kidney endpoint in obesity without diabetes; low absolute rates (1.8% vs 2.2%).

Effects of Semaglutide on Body Composition and GFR: A Prespecified Analysis of the SMART TrialRandomized trial · 2026 · Study tier 3 · Different population · Mixed · Industry funded
SMART: semaglutide reduced lean and fat mass; GFR estimates unaffected by body-composition change (n=101, 24 weeks).

02History