Among adults with type 2 diabetes and CKD, weekly semaglutide reduced the risk of major kidney events by about a quarter versus placebo; the trial stopped early for efficacy, with concordant benefits on cardiovascular events and survival.
In adults with obesity and cardiovascular disease but no diabetes, a prespecified secondary analysis found a lower composite kidney endpoint with semaglutide. This is a secondary kidney analysis within a cardiovascular-outcomes trial, not a dedicated kidney-outcome trial.
At 72 weeks (a planned interim analysis of the first 800 of 1,197 patients), more patients on semaglutide achieved resolution of steatohepatitis without worsening fibrosis than on placebo. This is liver (MASH) outcome evidence within the CKM continuum, not a kidney-outcome trial.
The dual GIP/GLP-1 agonist tirzepatide improved heart-failure outcomes and symptoms in HFpEF with obesity — a single positive trial on a cardiac endpoint, included here as it extends the CKM story to the heart; renal outcomes were not assessed.
A post-hoc analysis of SURPASS-4 (tirzepatide vs insulin glargine in T2D at high cardiovascular risk) found a lower composite kidney endpoint with tirzepatide, driven largely by reduced albuminuria. Exploratory, not a dedicated kidney-outcome trial.
Across the FIDELIO-DKD and FIGARO-DKD programme (FIDELITY pooled analysis), the non-steroidal mineralocorticoid-receptor antagonist finerenone reduced kidney and cardiovascular events in type 2 diabetes with CKD — the fourth pillar of cardio-reno-metabolic protection.
The first comprehensive clinical practice guideline for cardiovascular-kidney-metabolic syndrome, building on the AHA 2023 Presidential Advisory and its staging system (stages 0 through 4) of the CKM continuum.
Conclusions from the KDIGO Controversies Conference on the pathophysiology, prognosis, and management of obesity in CKD — with long-duration, early-onset obesity carrying the highest risk of incident CKD.
The ASN’s first guidance on managing obesity in people with kidney disease — spanning psychosocial care, lifestyle, pharmacotherapy, and metabolic/bariatric surgery within a multidisciplinary team.
The updated CKD evaluation-and-management guideline, including validated GFR-estimating equations for drug dosing and incorporation of cystatin C when creatinine-based eGFR is unreliable.