Glucagon-Like Peptide-1 Receptor Agonists in Chronic Kidney Disease: Mechanisms and Clinical Perspectives

Glucagon-like peptide-1 (GLP-1) receptor agonists are incretin-based therapies initially developed for the management of type 2 diabetes. In addition to improving glycemic control and promoting weight loss, these agents have demonstrated cardiovascular and potential renal benefits. This review explores the mechanisms by which GLP-1 receptor agonists may exert renoprotective effects, including modulation of inflammation, oxidative stress, fibrosis, endothelial dysfunction, and glomerular hemodynamics. We examine the expression of GLP-1 receptors in renal tissues and discuss preclinical data supporting their role in preserving kidney function, even in nondiabetic populations. Clinical trials such as SUSTAIN-6, REWIND, and FLOW provide evidence of GLP-1 receptor agonists reducing albuminuria and attenuating estimated glomerular filtration rate decline in patients with diabetic chronic kidney disease. Although further research is needed to define their role in nondiabetic chronic kidney disease, the growing body of evidence highlights GLP-1 receptor agonists as important agents in kidney protection. By integrating cellular mechanisms with clinical outcomes, this review offers a comprehensive understanding of their emerging role in the management of chronic kidney disease.