Tirzepatide Associated With Reduced Albuminuria in Participants With Type 2 Diabetes: Pooled Post Hoc Analysis From the Randomized Active- and Placebo-Controlled SURPASS-1-5 Clinical Trials
A pooled analysis of the SURPASS trials found that tirzepatide dose-dependently reduced albuminuria in people with type 2 diabetes — by up to about 26% at the highest dose — with the effect more pronounced in those with existing albuminuria and roughly half attributable to weight loss.
Background
Tirzepatide (a dual GIP/GLP-1 receptor agonist) reduced urine albumin-to-creatinine ratio (UACR) and slowed eGFR decline in the high-cardiovascular-risk SURPASS-4 trial. This analysis tested whether the albuminuria benefit generalizes to the broader type 2 diabetes population across the SURPASS program.
Study design
Post hoc analysis of the pooled SURPASS-1 to -5 randomized trials, examining change from baseline in UACR for tirzepatide 5, 10, and 15 mg versus active and placebo comparators, overall and in the subgroup with baseline UACR ≥30 mg/g, using a mixed model for repeated measures through week 40/42.
Key findings
Adjusted mean UACR reductions versus pooled comparators were −19.3% (5 mg), −22.0% (10 mg), and −26.3% (15 mg) at week 40/42, consistent across placebo, active, and insulin comparators. The reduction was more pronounced in participants with baseline UACR ≥30 mg/g, and mediation analysis suggested roughly half of the albuminuria reduction was weight-loss related. There was no difference in eGFR between tirzepatide and comparators at week 40/42.
Clinical implications
Tirzepatide produces a meaningful, dose-dependent reduction in albuminuria across a broad type 2 diabetes population, supporting potential kidney benefit beyond glucose control. As a post hoc analysis without a dedicated kidney-outcome endpoint, confirmation in prospective kidney-outcome trials is needed.
Category
Research
Source
Diabetes Care
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