Effect of Tirzepatide on Kidney Parameters in People with Excess Body Weight and Type 2 Diabetes: A Post-Hoc Analysis of the SURMOUNT-2 Trial

What was the potential impact of tirzepatide (TZP) vs. placebo (PBO) on kidney parameters in people with obesity or overweight with type 2 diabetes, based on a post-hoc analysis of the SURMOUNT-2 trial (SM-2)? Methods : Data from all participants randomly assigned to treatment were included (pooled TZP [10 and 15 mg], N=623; PBO, N=315). Assessments included CKD-EPI creatinine-cystatin-C-based eGFR (Cr-Cys-C-eGFR), and urine albumin-to-creatinine ratio (UACR). The change from baseline to week 72 was analyzed using mixed models for repeated measures with on-treatment data. Results : Baseline mean Cr-Cys-C-eGFR was 91.3±19.5 mL/min/1.73 m ^ 2. The estimated treatment difference (ETD) between pooled TZP groups and PBO on the change from baseline in Cr-Cys-C-eGFR was 0.0 mL/min/1.73 m ^ 2 (95% confidence interval [CI] -1.7, 1.7; p=0.993). TZP compared to placebo did not change Cr-Cys-C-eGFR at week 72 in participants with baseline Cr-Cys-C-eGFR<60 ml/min/1.73m ^ 2 (p=0.180) or≥60 ml/min/1.73m ^ 2 (p=0.714). Baseline median UACR was 13.0 mg/g (interquartile range 6.0–35.0 mg/g). UACR significantly decreased with TZP vs. PBO (ETD -31.1%, 95% CI -40.9, -19.7, p<0.001) and for those with baseline UACR≥30 mg/g, the ETD was -55.2% (95% CI -68.5, -36.4; p<0.001). Conclusion : In this post-hoc analysis SM-2 trial population of participants with obesity or overweight with T2D and preserved eGFR at baseline, TZP reduced albuminuria without adversely affecting eGFR. ^ denotes 'square root of' in this abstract Publication History Article published online: 28 May 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany