Reviews in Endocrine and Metabolic Disorders

, Volume 15, Issue 3, pp 197–207 | Cite as

Effects of GLP-1 in the Kidney



The incretin hormone, glucagon-like peptide-1 (GLP-1), stimulates insulin secretion and forms the basis of a new drug class for diabetes treatment. GLP-1 has several extra-pancreatic properties which include effects on kidney function. Although renal GLP-1 receptors have been identified, their exact localization and physiological role are incompletely understood. GLP-1 increases natriuresis through inhibition of the sodium-hydrogen ion exchanger isoform 3 in the proximal tubule. This may in part explain why GLP-1 receptor agonists have antihypertensive effects. Glomerular filtration rate is regulated by GLP-1, but the mechanisms are complex and may depend on e.g. glycaemic conditions. Atrial natriuretic peptide or the renin-angiotensin system may be involved in the signalling of GLP-1-mediated renal actions. Several studies in rodents have shown that GLP-1 therapy is renoprotective beyond metabolic improvements in models of diabetic nephropathy and acute kidney injury. Inhibition of renal inflammation and oxidative stress probably mediate this protection. Clinical studies supporting GLP-1-mediated renal protection exist, but they are few and with limitations. However, acute and chronic kidney diseases are major global health concerns and measures improving renal outcome are highly needed. Therefore, the renoprotective potential of GLP-1 therapy need to be thoroughly investigated in humans.


Glucagon-like peptide-1 Renal Glomerular filtration rate Natriuresis Diabetic nephropathy Acute kidney injury 



angiotensin II


acute kidney injury


atrial natriuretic peptide


angiotensin II receptor blocker


creatinine clearance


diabetic nephropathy


dipeptidyl peptidase IV


European Medicine Agency


end-stage renal disease


glucagon-like peptide-1


glucagon-like peptide-1 receptor


glomerular filtration rate


messenger ribonucleic acid


Na+/H+ exchanger isoform 3


protein kinase A


renin-angiotensin system


renal blood flow


reactive oxygen species


sodium-glucose linked transporter 2




type 2 diabetes mellitus


tubuloglomerular feedback


Conflict of interest

J.S. has a PhD fellowship in a joint collaboration between Aarhus University Hospital and Novo Nordisk.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Endocrinology and Internal MedicineAarhus University HospitalAarhusDenmark
  2. 2.Novo Nordisk A/SBagsvaerdDenmark

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