# GLP-1-remmers en SGLT2-remmers verkleinen perirenaal vet bij CKD-patiënten — ADIPO-CKD

*geplaatst 2026-10-21 · Hartfalen · Diabetes, obesity & metabolism · doi 10.1111/dom.71441 · https://hartvaat.nl/2026/10/13/glp-1-remmers-en-sglt2-remmers-verkleinen-perirenaal-vet-bij-ckd-patienten-adipo/*

In een prospectieve cohortstudie bij 80 patiënten met chronische nierinsufficiëntie (CKD) werd de verandering in perirenaal vetweefsel gemeten met echografie na acht maanden behandeling met GLP-1-remmers of SGLT2-remmers. Beide klassen verkleinden het perirenaal vet aanzienlijk ten opzichte van een controlegroep (-36,2% resp. -20,4%; p < 0,0001 resp. p = 0,0006), een effect dat niet verklaard werd door algemene gewichts- of vetmassaverlies. Deze depot-specifieke afname ondersteunt het mechanistische belang van deze cardiorenale medicijnen en biedt een nieuwe beeldvormende parameter voor toekomstig onderzoek naar nier- en hartcomplicaties.

## English: The Effects of GLP-1RA-Based and SGLT2 Inhibitor Therapy on Perirenal Adipose Tissue in CKD Patients.

In a prospective cohort study of 80 patients with chronic kidney disease (CKD), ultrasound-measured perirenal adipose tissue (PRAT) thickness was assessed after eight months of treatment with GLP-1 receptor agonists or SGLT2 inhibitors. Both drug classes significantly reduced PRAT compared to a reference group (-36.2% and -20.4%, respectively; p < 0.0001 and p = 0.0006), independent of overall weight or fat mass changes. These depot-specific reductions highlight a potential mechanistic pathway for the cardiorenal benefits of these agents and suggest PRAT as a promising imaging biomarker for future trials.

## Abstract (original, from the publication)

AIMS: Perirenal adipose tissue (PRAT) surrounds the kidney and may contribute to chronic kidney disease (CKD) progression. SGLT2 inhibitors have been associated with reductions in this depot, but PRAT has not been quantified under GLP-1RA-based therapy in CKD. We assessed ultrasound-measured PRAT thickness under both treatments and whether changes tracked weight loss. MATERIALS AND METHODS: Adults with CKD Stages 1-4 in the prospective ADIPO-CKD inception cohort underwent ultrasound at baseline and at the 8-month visit. PRAT thickness was the mean of right and left measurements; epicardial adipose tissue and body composition were also assessed. Patients received neither drug class (reference), SGLT2i or GLP-1RA-based therapy. Follow-up PRAT was analysed by covariance analysis adjusted for baseline. RESULTS: Of 277 patients, 80 had paired studies (32 reference, 24 SGLT2i, 24 GLP-1RA-based; body weight 46-122 kg). PRAT was unchanged in the reference group (+0.035 cm, p = 0.376) and decreased with SGLT2i (-0.273 cm, -20.4%, p = 0.0006) and GLP-1RA-based therapy (-0.463 cm, -36.2%, p < 0.0001). Adjusted differences versus reference were -0.227 cm (95% CI -0.417 to -0.036) and -0.433 cm (-0.622 to -0.244); under multiple imputations, -0.218 cm (-0.482 to +0.046) and -0.421 cm (-0.693 to -0.149). GLP-1RA-based therapy reduced body weight, fat mass and visceral fat area; SGLT2i only body weight, modestly. PRAT change correlated with none. CONCLUSIONS: In CKD, both drug classes were associated with lower follow-up PRAT, not explained by measured body-composition change. Under multiple imputations, both estimates were essentially unchanged, though the SGLT2i interval included no difference. PRAT may represent a candidate depot-specific target. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT07309094 (ADIPO-CKD).

Auteurs: Ana Checa-Ros, Oscar Arias-Mutis, Owahabanun-Joshua Okojie, Pilar Salvador, Luis D'Marco

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Bron: Diabetes, obesity & metabolism, https://doi.org/10.1111/dom.71441. Bijgewerkt 2026-10-14T01:27:44Z. 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.