Effect of GLP-1 RA Use on Kidney Outcomes in Young-Onset Type 2 Diabetes

Studies among patients aged 21 years and younger have shown that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with reductions in HbA1C and BMI. However, data on kidney outcomes in this patient population are limited.

To examine the effects of GLP-1 RAs on kidney function in adolescents and young adults with youth-onset type 2 diabetes (YO-T2D), researchers conducted a retrospective analysis of data from patients aged 21 years and younger who were prescribed a GLP-1 RA from January 2015 to May 2024 at the Joslin Diabetes Center in Boston, Massachusetts. Results were reported during the National Kidney Foundation Spring Clinical Meetings 2025.

The primary end point of interest was the change in urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) from the time of initiation of the GLP-1 RA to discontinuation or final follow-up. The secondary outcome of interest was change in HbA1c. The Chronic Kidney Disease in Children U25 calculation was used to determine eGFR.

Of the 52 patients, 58% were female, 34% were Black, and 16% were Hispanic. Mean age at initiation of GLP-1 RA was 17.3 years, and duration of diabetes was 2 years. A total of 63 GLP-1 RAs were started (37 dulaglutide, 13 semaglutide, 7 liraglutide, and 6 tirzepatide). Forty-one patients had confirmed continuation. The median duration of GLP-1 RA use was 1.4 years.

After initiation of GLP-1 RA, there was a decrease in HbA1c from 9.5% to 8.6%; (P=0.04).  No statistically significant changes were observed in UACR (9.6 mg/g vs 12.3 mg/g; P=0.11) or eGFR (128 mL/min/1.72 m² vs 121 mL/min/1.73 m²; P=0.67).

In summary, the authors said. “Patients with YO-T2D demonstrate early signs of diabetes-related kidney disease with a third experiencing albuminuria. GLP-1 RA reduced HbA1c significantly in patients treated for at least 4 months. Studies with longer follow-up are needed to investigate the role that GLP-1 RA have on kidney outcomes in the youth.”

Source: Mandel MC, Angus SA, Molina-Guzman J, Rosas SE. Glucagon-like peptide-receptor agonists (GLP-1 RA) and kidney outcomes in patients with youth-onset type 2 diabetes (YO-T2D). Abstract #G-418. Presented at the National Kidney Foundation Spring Clinical Meetings 2025; April 10-13, 2025; Boston, MA. doi:10.1053/j.ajkd.2025.02.419