What to Know about GLP-1 Medications If You Have Kidney Disease

Did you know that a medication for diabetes may also help protect your kidneys? GLP-1 medications, known for helping with weight loss, offer surprising benefits for people with kidney disease.

Dr. Holly Kramer, a nephrologist or kidney doctor, explains how these medications work and why they matter for kidney health.

• What Are GLP-1 Medications?
• Who May Benefit from GLP-1s?
• Why Weight Matters for Kidney Health
• Side Effects of GLP-1 Medications
• Types of GLP-1 Medications
• The Role of Lifestyle in Weight Loss
• Have Questions?

Listen to “GLP-1 Medications and Kidney Disease” on Spotify or Apple Podcasts.

GLP-1 (short for glucagon-like peptide-1) is a natural hormone made in the small intestine.

“Think of GLP-1 as a messenger that tells your brain and digestive system when you’ve had enough food,” said Dr. Kramer.

GLP-1:

• Slows digestion
• Lowers appetite
• Helps the body release insulin only when blood sugar is high

GLP-1 medications mimic these effects. This helps people feel full sooner, eat less, and manage blood sugar levels.

Continue learning how GLP-1 medications work.

GLP-1 medications are most often prescribed for people with:

• Type 2 diabetes
• Obesity or overweight

Not all GLP-1 medications are safe for everyone. If you have advanced kidney disease, a nephrologist will help determine whether these medications are a safe and effective option for you.

Extra weight puts a strain on the kidneys, forcing them to work harder.

“The strain can raise blood pressure and damage kidney function,” Dr. Kramer said. “The good news is that losing weight can lower levels of albumin in the urine, a sign of kidney damage.”

Albumin is an important protein that belongs in the blood.

“Lowering urine albumin by 25 to 30% may slow down the progression of kidney disease,” Dr. Kramer said.

By lowering this marker, you can help protect your kidney function.

Learn about other kidney protective medications.

Like most medicines, GLP-1 medications can cause side effects. Many are mild and improve over time.

Common side effects include:

• Nausea or vomiting: Often occurs when starting or increasing the dose. Eating smaller meals may help.
• Constipation or diarrhea: Staying hydrated and eating fiber-rich foods may reduce these symptoms.
• Muscle loss: Exercise and work with a dietitian to ensure you’re still getting enough protein.
• Headache or fatigue: Less common but possible.

Rare but more serious side effects include pancreatitis (inflammation of the pancreas) and gallbladder problems. 

Several GLP-1 medications are available. Some are taken daily, while others are weekly injections. If you experience side effects with one, another type may work better.

Common options include:

• Exenatide (Byetta): Two times a day injection
• Liraglutide (Victoza, Saxenda): Daily injection
• Dulaglutide (Trulicity): Weekly injection
• Semaglutide (Ozempic, Rybelsus, Wegovy): Weekly injection or daily pill
• Tirzepatide (Mounjaro, Zepbound): Weekly injection; Works on the GLP-1 hormone and another called GIP for added benefit

Your doctor will recommend the best option based on your health, lifestyle, and treatment goals.

Here’s what to ask your healthcare team about GLP-1 medications.

GLP-1s are powerful tools, but they work best alongside healthy habits.

“They’re great medications, but don’t use them alone,” Dr. Kramer said. “Combine them with lifestyle interventions like meeting with a dietitian, eating less processed foods, and finding ways to be more physically active.”

People who use GLP-1s without lifestyle changes may gain weight back after stopping the medication.  

“Think of them as something to boost your efforts with diet and exercise, not replace them,” Dr. Kramer said.

Learn more about lifestyle changes that protect the kidneys.

Reach out to NKF Cares. Call toll-free at 855.653.2273 or send us a message for support and answers about kidney health.