# GLP-1-agonisten en multi-hormoonmodulatoren bieden nierbescherming bij niet-diabetische chronische nierziekte

*geplaatst 2026-10-27 · Nierziekte · Journal of the American Society of Nephrology : JASN · doi 10.1681/ASN.0000001306 · https://hartvaat.nl/2026/10/19/glp-1-agonisten-en-multi-hormoonmodulatoren-bieden-nierbescherming-bij-niet-diab/*

Deze review belicht de nierbeschermende effecten van GLP-1-agonisten en nieuwere multi-hormoonmodulatoren bij patiënten met niet-diabetische chronische nierziekte. De werking verloopt via directe mechanismen zoals natriuresis en verbetering van de glomerulaire hemodynamica, en indirect via gewichtsverlies, bloeddrukdaling en verbetering van hartfalen. Uit lopende fase-3-obesitas- en CV-outcomestudies blijkt reeds een reductie in albuminurie en een betere stabilisatie van de eGFR. Deze bevindingen onderstrepen dat deze farmaca binnenkort een nieuwe pijler kunnen worden in de nierbescherming, naast de huidige standaardtherapie.

## English: Glucagon-Like Peptide-1 Receptor Agonists and Multi-hormone Receptor Modulators for Kidney Protection in Nondiabetic Kidney Disease.

This review examines the renal protective effects of GLP-1 receptor agonists and newer multi-hormone receptor modulators in patients with non-diabetic chronic kidney disease. Benefits arise through direct mechanisms, including natriuresis and modulation of glomerular hemodynamics, as well as indirect pathways driven by weight loss, blood pressure reduction, and improved heart failure status. Emerging data from phase-3 cardiovascular and obesity trials already demonstrate reduced albuminuria and better preservation of eGFR. These findings position these agents as a promising new pillar in nephroprotection, with dedicated outcome trials currently underway to confirm clinical efficacy.

## Abstract (original, from the publication)

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), together with newer multi-hormone receptor modulators that target glucose-dependent insulinotropic polypeptide (GIP), glucagon and amylin, have emerged as promising therapies for chronic kidney disease. This review examines the mechanisms through which these agents may protect the kidney and summarizes the emerging clinical evidence in populations without diabetes. Kidney protection appears to arise through complementary direct and indirect routes. Direct effects include natriuresis through inhibition of the sodium-hydrogen exchanger (NHE)-3, modulation of glomerular hemodynamics through effects on afferent arteriolar tone and vasoconstrictor pathways, and attenuation of renal inflammation; mechanisms that are largely independent of glucose lowering. Indirect mechanisms include reductions in the metabolic, hemodynamic and cardiac burden on the kidney through weight loss, blood pressure lowering, and improvement of heart failure. Beyond selective GLP-1R-agonism, the added hormonal components of multi-hormone receptor modulators engage distinct physiological pathways whose interactions may be additive, synergistic or counteracting, but remain incompletely understood. The efficacy of GLP-1 RAs and multi-hormone receptor modulators in people without diabetes is currently supported by results from secondary kidney endpoints in phase-3 obesity and cardiovascular outcome trials, including reductions in albuminuria and preservation of estimated glomerular filtration rate. Several dedicated outcome studies of GLP-1 RAs and multi-hormone receptor modulators are now underway and will determine whether these therapies become a new pillar of care in nondiabetic kidney disease.

Auteurs: Sachin V Pasricha, Labib I Faruque, Mai Mohsen, Tyler D Brown, Kevin Yau, Kyle D Medak, David Z I Cherney, Marcel H A Muskiet, Ayodele Odutayo

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Bron: Journal of the American Society of Nephrology : JASN, https://doi.org/10.1681/ASN.0000001306. Bijgewerkt 2026-10-20T01:07:05Z. 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.