# Orforglipron: stabiele nierfunctie in fase-3-trials, maar nier-specifieke uitkomsten blijven onduidelijk

*geplaatst 2026-09-17 · Nierziekte · American journal of nephrology · doi 10.1159/ajn/ablag011 · https://hartvaat.nl/2026/09/09/orforglipron-stabiele-nierfunctie-in-fase-3-trials-maar-nier-specifieke-uitkomst/*

Een narratieve review analyseert de nierfunctie-effecten van orforglipron, de eerste orale niet-peptide GLP-1-receptoragonist. Fase-3-trials tonen significante dalingen in HbA1c, lichaamsgewicht en cardiovasculaire risicomarkers, gepaard gaand met een stabiele eGFR en geen aanwijzingen voor nier toxiciteit. Omdat deze studies niet waren gepowerd voor nier-specifieke uitkomsten en patiënten met gevorderde CKD ondervertegenwoordigd waren, blijft de effectiviteit en veiligheid in deze groep inferentieel. Nier-specifieke trials zijn nodig om orforglipron veilig te integreren in de nefrologische behandelalgoritmen.

## English: Orforglipron and the Kidney: A Promise or Disappointment? The Need for Trials Examining Renal Outcomes.

A narrative review examines the renal effects of orforglipron, the first oral non-peptide GLP-1 receptor agonist. Phase 3 trials demonstrate significant reductions in HbA1c, body weight, and cardiovascular risk markers alongside stable eGFR, with no signals of renal toxicity. However, as these studies were not powered for renal endpoints and excluded advanced chronic kidney disease populations, the drug’s renal safety and efficacy remain inferential. Dedicated nephrology trials are required to define its role in cardiorenal treatment algorithms.

## Abstract (original, from the publication)

Orforglipron, the first oral non-peptide GLP-1 receptor agonist, has a pharmacokinetic and formulation profile that may be theoretically attractive for patients with chronic kidney disease (CKD) including hepatic metabolism with minimal renal excretion and removal of potential barriers associated with current injectable and other oral formulations. We utilized a literature search utilizing PubMed/MEDLINE and ClinicalTrials. gov from their respective inceptions through May 2026 to synthesize a review on orforglipron. Phase 3 trials demonstrated significant reductions in hemoglobin A1c, body weight, and cardiovascular risk markers with stable eGFR and no indications of significant renal toxicity. These trials however were not designed or powered to evaluate renal outcomes including eGFR, albuminuria, and kidney failure progression. Additionally, previous trials were noted to have underrepresented or excluded populations of patients with advanced CKD, thus renal effects are inferential barring further clinical investigation, though a current trial examining kidney and cardiovascular outcomes in patients with both atherosclerosis and CKD is underway. Future CKD-specific trials are necessary to determine the safety, efficacy, and potential integration of orforglipron into nephrology treatment algorithms.

Auteurs: Joel Shah, Eder Luna Ceron, Fernanda Payan-Schober, Lisa Aimee Hechanova, Deborah Joy Clegg, Biff F Palmer

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Bron: American journal of nephrology, https://doi.org/10.1159/ajn/ablag011. Bijgewerkt 2026-09-10T01:13:21Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.