Nephrology ·
Lilly reports slower eGFR decline with orforglipron; semaglutide misses coprimary MRI end points in REMODEL; NKF says genetic testing should widen
THE SHORT READ
In the ACHIEVE-4 trial, the oral GLP-1 drug orforglipron was associated with slower kidney function decline and a larger albuminuria reduction than insulin glargine, Eli Lilly reported. In the REMODEL trial, semaglutide did not significantly alter kidney oxygenation, perfusion or inflammation on imaging, the coprimary outcomes; albuminuria fell in an exploratory analysis. The National Kidney Foundation said genetic testing should move beyond specialty centers.
THE DETAILS
- Research Sept 30, 2026Eli Lilly said its oral GLP-1 drug orforglipron (Foundayo) was associated with slower decline in kidney function than insulin glargine in the ACHIEVE-4 trial, including a 2.8 mL/min/1.73 m² smaller reduction in estimated glomerular filtration rate and a 27.1% greater reduction in albuminuria. Lilly said those results used the efficacy estimand and were not controlled for family-wise type 1 error. The open-label trial, published in The Lancet, randomized 2,749 adults with type 2 diabetes and obesity or overweight at increased cardiovascular risk and met its noninferiority criterion for major adverse cardiovascular events (hazard ratio 0.84; 95% CI 0.59 to 1.20).Sources: Eli Lilly, The Lancet (abstract on PubMed)
- Research Oct 1, 2026In the REMODEL trial, published Oct. 1 in Nature Medicine, 106 participants with type 2 diabetes and chronic kidney disease received semaglutide 1 mg weekly or placebo for 52 weeks, with multiparametric kidney magnetic resonance imaging and, in 33, kidney biopsy. The coprimary imaging outcomes, oxygenation, global perfusion and tissue inflammation, were not significantly altered by semaglutide. In secondary outcomes, semaglutide was associated with a reduced renal artery resistive index and a stable apparent diffusion coefficient, which the authors said indicates prevention of fibrosis progression. In an exploratory outcome, the urine albumin-to-creatinine ratio fell 40% versus placebo (P = .008).Source: Nature Medicine
- Guidelines Sept 30, 2026The National Kidney Foundation (NKF) said a central message of its Genetics in Kidney Health Summit, held Sept. 18 to 19 in Dallas, was that genetic testing can no longer remain limited to a small number of specialty centers. Community nephrologists can identify appropriate patients, explain testing, interpret results with expert support and coordinate follow-up care, the foundation said. Sessions covered deciding who may benefit, informed consent, sample collection, communicating results and when to involve genetic counselors. The NKF said it will use the summit's insights to support education and implementation of genetic testing.Source: National Kidney Foundation
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