Comparative Effectiveness of SGLT2 Inhibitors and Semaglutide in Diabetic Nephropathy: A Retrospective Observational Study.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have demonstrated renal benefits beyond glycemic control in patients with type 2 diabetes mellitus (T2DM). This study compares renal outcomes and metabolic parameters in 10 patients with early diabetic nephropathy, five treated with SGLT2 inhibitors (empagliflozin or dapagliflozin) and five with semaglutide, a type of GLP-1 receptor agonist. Over a six-month follow-up, both groups showed improvement in albuminuria and estimated glomerular filtration rate eGFR) stabilization. However, semaglutide recipients had greater reductions in body weight and HbA1c, while SGLT2 inhibitor users exhibited more consistent declines in albuminuria. Both agents were well tolerated. This comparative series highlights the complementary nephroprotective profiles of both drug classes, supporting their individualized use in managing diabetic kidney disease. Further randomized trials are warranted to determine optimal sequencing or combination strategies.