Evidence map›Paper›PMID 40359159›Full record

ReviewNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2025

How to individualize renoprotective therapy in obese patients with chronic kidney disease: a commentary by the Diabesity Working Group of the ERA.

Enrique Morales, William P Martin, Sebastjan Bevc, Trond G Jenssen, Marius Miglinas, Matias Trillini

Abstract readReview
In one paragraph

Review in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Cardiorenal outcomes of weight loss interventions in people with CKD and type 2 diabetes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Article
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Enrique MoralesDepartment of Nephrology, Hospital 12 de Octubre, Madrid, Spain.ORCID 0000-0002-5824-6973
William P MartinDivision of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Sebastjan BevcDepartment of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia.
Trond G JenssenDepartment of Transplantation Medicine, Section of Nephrology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Marius MiglinasCenter of Nephrology, Santaros Klinikos, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Matias TrilliniIstituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.

Funding

European Renal Association
6 · The paper itself

Abstract

The interrelated pandemics of obesity and type 2 diabetes mellitus (T2DM) are fuelling an increase in the prevalence of chronic kidney disease (CKD), which amplifies the risk of cardiovascular events and may progress to end-stage kidney disease (ESKD). Treatment options for such patients have rapidly expanded over the past decade and continue to evolve. Herein, we primarily focus on glucagon-like peptide-1 receptor agonists (GLP-1RAs) and their role in the management of CKD in the setting of overweight/obesity and T2DM. Recommendations from the recent Kidney Disease: Improving Global Outcomes CKD guidelines are summarized and new evidence arising since publication of these guidelines is highlighted. We review clinical studies supporting the role of GLP-1RAs in patients with diabesity and CKD, including the FLOW trial, as well as exploring potential mechanisms of their nephroprotective effects. Their role in the management of patients with ESKD on maintenance dialysis and after kidney transplantation, while less evidence-based, is also discussed. The potential for other gut hormone-based therapies, including GLP-1/glucose-dependent insulinotropic polypeptide dual agonists (tirzepatide), triple agonists (incorporating glucagon agonism) and amylin analogues to improve cardiovascular and kidney outcomes in patients with CKD, is explored. We highlight the role of novel therapies distinct from the gut-kidney axis, including non-steroidal mineralocorticoid receptor antagonists (nsMRAs). We outline the potential for multitarget therapy incorporating renin-angiotensin-aldosterone system inhibitors, sodium-glucose co-transporter-2 inhibitors, incretin-based treatments and nsMRAs to improve cardiovascular and kidney outcomes in patients with overweight/obesity and T2DM. Current unknowns in the timing and sequence of multitarget therapy in patients with CKD are emphasized. Priority research questions for the future are highlighted throughout the review.

Indexed as

Diabetes Mellitus, Type 2ObesityPrecision MedicineRenal Insufficiency, ChronicDiabesityGlucagon-Like Peptide-1 Receptor AgonistsHumansPrognosisGlucagon-Like Peptide-1 Receptor AgonistsCKDincretinobesityrenoprotectivetype 2 diabetes

Identifiers

PMID40359159
PMCPMC12548029

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.