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Article

Comparative Effects of Dulaglutide and Semaglutide on Renal Function Decline and Proteinuria Reduction in Diabetic Patients: A Retrospective Cohort Study

by
Yuh-Mou Sue
1,2,3,
De-En Lu
2,
Te-I Chang
4,5,6,
Chun-You Chen
7,8,9,
Cheng-Hsien Chen
1,2,10,
Shih-Chang Hsu
11,12,
Yen-Ling Chu
2,
Nai-Jen Huang
2,
Tso-Hsiao Chen
1,2,
Feng-Yen Lin
1,13,
Chun-Ming Shih
1,13,
Po-Hsun Huang
14,
Hui-Ling Hsieh
15,16,† and
Chung-Te Liu
1,2,*,†
1
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
2
Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
3
Division of Nephrology, Hsin Kuo Min Hospital, Taipei Medical University, Taoyuan 320, Taiwan
4
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
5
Division of Cardiovascular Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
6
Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617, Taiwan
7
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
8
Artificial Intelligence Research and Development Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
9
Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
10
Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
11
Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
12
Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
13
Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan
14
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
15
Second Degree Bachelor of Science in Nursing Collage of Medicine, National Taiwan University, Taipei 100, Taiwan
16
Department of Nursing, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
 
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*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2025, 14(12), 4287; https://doi.org/10.3390/jcm14124287
Submission received: 19 April 2025 / Revised: 21 May 2025 / Accepted: 12 June 2025 / Published: 16 June 2025
(This article belongs to the Section Nephrology & Urology)
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Abstract

Background: GLP-1 receptor agonists (GLP-1 RAs) lower glucose and reduce cardiovascular events in type 2 diabetes, with noted renal benefits. Few studies directly compare GLP-1 RAs. This study aims to compare the effects of semaglutide and dulaglutide on renal function decline and proteinuria reduction in diabetic patients. Methods: The present study was conducted at Wanfang Hospital, Taipei Medical University. Diabetic patients using either semaglutide or dulaglutide for more than 1 year in the outpatient department from 1 January 2022 to 30 September 2024 were enrolled retrospectively. The outcome events in the present study included a decline in the estimated glomerular filtration rate (eGFR), an increase in the urine albumin–creatinine ratio (UACR), and patient death. Results: A total of 268 patients on dulaglutide and 747 on semaglutide were included. Baseline eGFR levels were similar in both groups. After 12 months, eGFR levels did not significantly decline in both groups. However, the dulaglutide group showed significantly higher UACR increases than the semaglutide group (p < 0.01). More death events also occurred in the dulaglutide group (p < 0.01). Multivariate logistic regression revealed a higher risk of UACR increase with dulaglutide (p < 0.01). Subgroup analysis found dulaglutide associated with higher UACR in patients younger than 60, males, those with hypertension, without heart failure, those using angiotensin receptor blockers, biguanides, and statins, and those not using sodium-glucose cotransporter-2 inhibitors. Conclusions: Dulaglutide and semaglutide had comparable effects on slowing eGFR decline. However, dulaglutide was less effective in reducing UACR, particularly in the subgroups mentioned above.
Keywords: albuminuria; dulaglutide; glucagon like peptide 1 receptor agonist (GLP-1 RA); proteinuria; renal function; semaglutide albuminuria; dulaglutide; glucagon like peptide 1 receptor agonist (GLP-1 RA); proteinuria; renal function; semaglutide
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MDPI and ACS Style

Sue, Y.-M.; Lu, D.-E.; Chang, T.-I.; Chen, C.-Y.; Chen, C.-H.; Hsu, S.-C.; Chu, Y.-L.; Huang, N.-J.; Chen, T.-H.; Lin, F.-Y.; et al. Comparative Effects of Dulaglutide and Semaglutide on Renal Function Decline and Proteinuria Reduction in Diabetic Patients: A Retrospective Cohort Study. J. Clin. Med. 2025, 14, 4287. https://doi.org/10.3390/jcm14124287

AMA Style

Sue Y-M, Lu D-E, Chang T-I, Chen C-Y, Chen C-H, Hsu S-C, Chu Y-L, Huang N-J, Chen T-H, Lin F-Y, et al. Comparative Effects of Dulaglutide and Semaglutide on Renal Function Decline and Proteinuria Reduction in Diabetic Patients: A Retrospective Cohort Study. Journal of Clinical Medicine. 2025; 14(12):4287. https://doi.org/10.3390/jcm14124287

Chicago/Turabian Style

Sue, Yuh-Mou, De-En Lu, Te-I Chang, Chun-You Chen, Cheng-Hsien Chen, Shih-Chang Hsu, Yen-Ling Chu, Nai-Jen Huang, Tso-Hsiao Chen, Feng-Yen Lin, and et al. 2025. "Comparative Effects of Dulaglutide and Semaglutide on Renal Function Decline and Proteinuria Reduction in Diabetic Patients: A Retrospective Cohort Study" Journal of Clinical Medicine 14, no. 12: 4287. https://doi.org/10.3390/jcm14124287

APA Style

Sue, Y.-M., Lu, D.-E., Chang, T.-I., Chen, C.-Y., Chen, C.-H., Hsu, S.-C., Chu, Y.-L., Huang, N.-J., Chen, T.-H., Lin, F.-Y., Shih, C.-M., Huang, P.-H., Hsieh, H.-L., & Liu, C.-T. (2025). Comparative Effects of Dulaglutide and Semaglutide on Renal Function Decline and Proteinuria Reduction in Diabetic Patients: A Retrospective Cohort Study. Journal of Clinical Medicine, 14(12), 4287. https://doi.org/10.3390/jcm14124287

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