GLP-1 受體促效劑在腎臟與心血管代謝保護的新進展
Abstract List
20 Sep 2026
14:30
15:00
Ming-Tso YenTaiwan
Speaker
GLP-1 受體促效劑在腎臟與心血管代謝保護的新進展The coexistence of type 2 diabetes mellitus, obesity, chronic kidney disease (CKD), and cardiovascular disease has prompted a shift from isolated glycemic management toward integrated cardiovascular–kidney–metabolic (CKM) risk reduction. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) provide effective glycemic control and weight reduction, while accumulating evidence supports clinically meaningful cardiovascular and renal benefits beyond their metabolic effects. In randomized cardiovascular outcome trials and meta-analyses, GLP-1 RAs have reduced major adverse cardiovascular events (MACE), all-cause mortality, albuminuria, and composite kidney outcomes, with generally consistent effects across baseline CKD categories.
This presentation will review the current evidence for GLP-1 RA–mediated cardiorenal protection, with emphasis on recent outcome trials, including SELECT and FLOW. Particular attention will be given to the FLOW trial, which evaluated kidney outcomes as a prespecified primary endpoint and demonstrated a reduction in clinically relevant kidney-disease outcomes among patients with type 2 diabetes and CKD treated with semaglutide. The potential mechanisms underlying these benefits will also be discussed, including weight loss, improved insulin sensitivity, blood-pressure reduction, attenuation of systemic and vascular inflammation, improved endothelial function, and possible direct effects on intrarenal hemodynamics, oxidative stress, and immunometabolic pathways.
The presentation will further examine the complementary roles of GLP-1 RAs and sodium–glucose cotransporter-2 (SGLT2) inhibitors in CKM risk management. Available evidence suggests that the cardiovascular and kidney benefits of GLP-1 RAs may persist irrespective of background SGLT2 inhibitor use, although the extent of additive benefit and the optimal sequencing or combination strategy require further investigation. Practical issues—including gastrointestinal adverse effects, volume depletion, acute kidney injury risk in the setting of severe gastrointestinal intolerance, gallbladder disease, nutritional status, sarcopenia, and treatment monitoring in advanced CKD—will also be addressed.
By integrating mechanistic insights with contemporary clinical-trial data, this lecture will discuss how GLP-1 RAs may be incorporated into individualized treatment strategies for patients with diabetes, obesity, CKD, and high cardiovascular risk. The presentation will also emphasize that treatment decisions should remain patient-centered and evidence-based, recognizing that cardiovascular and renal effects may differ among individual agents, populations, and clinical indications.