News & Views | Published:


Renoprotective effects of dulaglutide in patients with T2DM and CKD

Nature Reviews Nephrology (2018) | Download Citation

The AWARD-7 trial shows that the glucagon-like peptide 1 (GLP1) receptor agonist dulaglutide, which is not cleared by the kidney, seems to be renoprotective, ameliorates albuminuria and slows estimated glomerular filtration rate decline in patients with type 2 diabetes mellitus and chronic kidney disease, without increasing the risk of hypoglycaemia.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1.

    Holst, J. J. The physiology of glucagon-like peptide 1. Physiol. Rev. 87, 1409–1439 (2007).

  2. 2.

    Muskiet, M. H. A. et al. GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetes. Nat. Rev. Nephrol. 13, 605–628 (2017).

  3. 3.

    Tuttle, K. R. et al. Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate-to-severe chronic kidney disease (AWARD-7): a multicentre, open-label, randomised trial. Lancet Diabetes Endocrinol. 6, 605–617 (2018).

  4. 4.

    Pyke, C. et al. GLP-1 receptor localization in monkey and human tissue: novel distribution revealed with extensively validated monoclonal antibody. Endocrinology 155, 1280–1290 (2014).

  5. 5.

    Jensen, E. P. et al. Activation of GLP-1 receptors on vascular smooth muscle cells reduces the autoregulatory response in afferent arterioles and increases renal blood flow. Am. J. Physiol. Renal Physiol. 308, F867–F877 (2015).

  6. 6.

    Fujita, H. et al. The protective roles of GLP-1R signaling in diabetic nephropathy: possible mechanism and therapeutic potential. Kidney Int. 85, 579–589 (2014).

  7. 7.

    Asmar, A. et al. Glucagon-like peptide-1 does not have acute effects on central or renal hemodynamics in patients with type 2 diabetes without nephropathy. Am. J. Physiol. Endocrinol. Metab. 310, E744–E753 (2016).

  8. 8.

    Idorn, T. et al. Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease: an investigator-initiated, placebo-controlled, double-blind, parallel-group, randomized trial. Diabetes Care 39, 206–213 (2016).

  9. 9.

    Chaudhuri, A. et al. Exenatide exerts a potent antiinflammatory effect. J. Clin. Endocrinol. Metab. 97, 198–207 (2012).

  10. 10.

    Verma, S. et al. Effect of liraglutide on cardiovascular events in patients with type 2 diabetes mellitus and polyvascular disease: results of the LEADER trial. Circulation 137, 2179–2183 (2018).

Download references

Author information


  1. Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark

    • Charlotte M. Sorensen
    •  & Jens J. Holst


  1. Search for Charlotte M. Sorensen in:

  2. Search for Jens J. Holst in:

Competing interests

J.J.H. serves as a consultant for Novo Nordisk A/S and Merck Sharp & Dohme (MSD). C.M.S. declares no competing interests.

Corresponding author

Correspondence to Jens J. Holst.

About this article

Publication history



Newsletter Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing