In the placebo-controlled, randomized LEADER trial, treatment with liraglutide (Victoza) lowered the incidence of adverse cardiovascular (CV) outcomes in 9340 patients with longstanding type 2 diabetes, most of whom had known CV disease at baseline (NEJM JW Gen Med Jul 15 2016 and N Engl J Med 2016; 375:311). Now, the researchers report positive renal outcomes as well. At baseline, participants' mean age was 64, mean glycosylated hemoglobin (HbA1c) was 8.7%, and mean estimated glomerular filtration rate (eGFR) was 80 mL/minute/1.73 m².

During average follow-up of 4 years, incidence of a combined renal endpoint (new-onset persistent macroalbuminuria, doubling of serum creatinine, end-stage renal disease, or renal-related death) was significantly lower with liraglutide than with placebo (5.7% vs. 7.2%). New-onset persistent macroalbuminuria accounted for most of this difference. Among patients whose baseline eGFR was between 30 and 60 mL/minute/1.73 m², mean eGFR declined less with liraglutide than with placebo (by 2 mL/minute/1.73 m²), but no difference was seen in patients whose baseline eGFRs were outside this range.

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