A comparison of the effects of tirzepatide and dulaglutide on major kidney events in people with type 2 diabetes: pre-specified exploratory analyses of the SURPASS-CVOT trial.

Zoungas S, D'Alessio D, Pavo I, Bhatt DL, Buse JB, Prato SD, Kahn SE, Lincoff AM, McGuire DK, Nauck MA, Nissen SE, Sattar N and 12 more

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Zinman B, Ceriello A, Stechemesser L, Verhaegen A, Broder JC, Wolfe R, Miller D, Nishiyama H, Wang X, Weerakkody G, Wiese RJ, Nicholls SJ

The lancet. Diabetes & endocrinology11 May 2026Cited by 5 (Europe PMC)

PMID42114520DOI10.1016/s2213-8587(26)00032-xPepBankPUB-42114520

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Summary

BackgroundIn the SURPASS-CVOT trial, tirzepatide, a dual incretin agonist that targets the glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, was shown to be non-inferior to dulaglutide for the primary composite cardiovascular outcome in people with type 2 diabetes and atherosclerotic cardiovascular disease. Here, we report the results of a pre-specified exploratory analysis of SURPASS-CVOT that aimed to assess major kidney events in the overall population, low-to-moderate-risk chronic kidney disease population, and high-risk chronic kidney disease population.MethodsSURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries. Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg. Annual visits included assessment of serum creatinine, cystatin C, and urine albumin-to-creatinine ratio (UACR). High-risk chronic kidney disease was defined by an estimated glomerular filtration rate (eGFR) of 60 mL/min per 1·73 m² or greater and UACR greater than 300 mg/g; eGFR 45 mL/min per 1·73 m² to less than 60 mL/min per 1·73 m² and UACR greater than 30 mg/g; or eGFR less than 45 mL/min per 1·73 m², with eGFR calculated with the CKD-Epidemiology Collaboration serum creatinine-cystatin C equation. The primary composite kidney outcome was time to first occurrence of persistent macroalbuminuria, persistent reduction in eGFR of 50% or greater, end-stage kidney disease (eGFR 2 or initiation of chronic kidney replacement therapy), or death from kidney disease.FindingsBetween May 29, 2020, and June 27, 2022, 16 979 participants were screened and 13 299 (2948 with high-risk chronic kidney disease) were randomly assigned. After excluding 134 participants randomly assigned in error, 6586 were assigned to tirzepatide and 6579 were assigned to dulaglutide. At baseline, 4142 (32·0%) of 12 954 participants had microalbuminuria and 1491 (11·5%) of 12 954 had macroalbuminuria, and 2928 (22·5%) of 13 004 had an eGFR less than 60 mL/min per 1·73 m². After a median follow-up of 4·0 (IQR 3·7-4·4) years, the risk of the primary composite kidney outcome in the overall population was 23% lower with tirzepatide than with dulaglutide (396 [6·0%] vs 498 [7·6%] events, hazard ratio 0·77 [95% CI 0·68 to 0·88], p=0·0002) and was similarly reduced in those with low-to-moderate-risk chronic kidney disease (195 [4·0%] vs 283 [5·6%], 0·70 [0·58 to 0·84], p=0·0001) and those with high-risk chronic kidney disease (185 [12·2%] vs 203 [14·5%], 0·79 [95% CI 0·64 to 0·96], p=0·018). This was primarily driven by a lower rate of new-onset persistent macroalbuminuria in those with low-to-moderate-risk chronic kidney disease and a lower rate of eGFR decline in those with high-risk chronic kidney disease. Observations were consistent in all other subgroups examined. The annual rate of decline in eGFR was lower with tirzepatide than with dulaglutide in the overall population (between-group difference 0·29 mL/min per 1·73 m² [95% CI 0·17 to 0·41]; p<0·0001) and in those with high-risk chronic kidney disease (0·93 mL/min per 1·73 m² [0·65 to 1·22], p<0·0001). Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.InterpretationAmong people with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was associated with a reduced risk of major kidney events compared with dulaglutide, primarily driven by a reduction in new-onset macroalbuminuria in people with low-to-moderate-risk chronic kidney disease, and slowed decline in kidney function in people with high-risk chronic kidney disease.FundingEli Lilly and Company.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study19

19 results from studies that gave the peptide. 19 results from people.

01HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide lowered the risk of the primary composite kidney outcome by 23% versus dulaglutide (hazard ratio 0·77).
In plain wordsIn people with type 2 diabetes and heart disease, tirzepatide cut the risk of major kidney events by 23% compared with dulaglutide.
Peptide
Tirzepatide
Outcome
DecreasePrimary composite kidney outcome, overall population
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Measurements
Hazard ratio
0.77 ratio
overall population
Source sentences
Summary
the risk of the primary composite kidney outcome in the overall population was 23% lower with tirzepatide than with dulaglutide (396 [6·0%] vs 498 [7·6%] events, hazard ratio 0·77 [95% CI 0·68 to 0·88], p=0·0002)
2 context sentences(design, population, supporting numbers)
Summary · context
The primary composite kidney outcome was time to first occurrence of persistent macroalbuminuria, persistent reduction in eGFR of 50% or greater, end-stage kidney disease (eGFR 2 or initiation of chronic kidney replacement therapy), or death from kidney disease.
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452001
02HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and low-to-moderate-risk chronic kidney disease, tirzepatide lowered the risk of the primary composite kidney outcome versus dulaglutide (hazard ratio 0·70).
In plain wordsIn people with type 2 diabetes and mild-to-moderate kidney disease risk, tirzepatide lowered the risk of major kidney events compared with dulaglutide.
Peptide
Tirzepatide
Outcome
DecreasePrimary composite kidney outcome, low-to-moderate-risk CKD
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Measurements
Hazard ratio
0.7 ratio
low-to-moderate-risk CKD
Source sentences
Summary
similarly reduced in those with low-to-moderate-risk chronic kidney disease (195 [4·0%] vs 283 [5·6%], 0·70 [0·58 to 0·84], p=0·0001)
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452002
03HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and high-risk chronic kidney disease, tirzepatide lowered the risk of the primary composite kidney outcome versus dulaglutide (hazard ratio 0·79).
In plain wordsIn people with type 2 diabetes and high-risk kidney disease, tirzepatide lowered the risk of major kidney events compared with dulaglutide.
Peptide
Tirzepatide
Outcome
DecreasePrimary composite kidney outcome, high-risk CKD
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Measurements
Hazard ratio
0.79 ratio
high-risk CKD
Source sentences
Summary
those with high-risk chronic kidney disease (185 [12·2%] vs 203 [14·5%], 0·79 [95% CI 0·64 to 0·96], p=0·018)
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452003
04HumanRandomized controlled trialEfficacy outcome
In people with diabetes and atherosclerotic cardiovascular disease, dulaglutide had a higher composite kidney event risk than tirzepatide.
In plain wordsIn people with diabetes and artery disease, dulaglutide had more combined kidney events than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseComposite kidney outcome in overall population
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Kidney function · Kidney and urinary
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Measurements
patients with primary composite kidney outcome, dulaglutide
498 events
dulaglutide 1·5 mg, overall population
proportion with primary composite kidney outcome, dulaglutide
7.6%
dulaglutide 1·5 mg, overall population
patients with primary composite kidney outcome, tirzepatide
396 events
tirzepatide up to 15 mg, overall population
proportion with primary composite kidney outcome, tirzepatide
6%
tirzepatide up to 15 mg, overall population
hazard ratio, primary composite kidney outcome
0.77 HR
tirzepatide versus dulaglutide, overall population
95% CI of hazard ratio
0.68 to 0.88 HR
tirzepatide versus dulaglutide, overall population
Source sentences
Summary
After a median follow-up of 4·0 (IQR 3·7-4·4) years, the risk of the primary composite kidney outcome in the overall population was 23% lower with tirzepatide than with dulaglutide (396 [6·0%] vs 498 [7·6%] events, hazard ratio 0·77 [95% CI 0·68 to 0·88], p=0·0002)
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452011
05HumanRandomized controlled trialEfficacy outcome
In participants with diabetes and atherosclerotic cardiovascular disease, annual eGFR decline was greater with dulaglutide than tirzepatide.
In plain wordsIn people with diabetes and artery disease, kidney filtration declined faster with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseAnnual eGFR decline in overall population
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Kidney function · Kidney and urinary
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Measurements
between-group difference in annual eGFR decline
0.29 mL/min per 1·73 m2
tirzepatide versus dulaglutide, overall population
95% CI of difference
0.17 to 0.41 mL/min per 1·73 m2
tirzepatide versus dulaglutide, overall population
Source sentences
Summary
The annual rate of decline in eGFR was lower with tirzepatide than with dulaglutide in the overall population (between-group difference 0·29 mL/min per 1·73 m² [95% CI 0·17 to 0·41]; p<0·0001)
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452016
06HumanRandomized controlled trialSafety outcome
In participants with diabetes and atherosclerotic cardiovascular disease, nausea was less common with dulaglutide than tirzepatide.
In plain wordsIn people with diabetes and artery disease, nausea occurred less often with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseNausea
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452017
07HumanRandomized controlled trialSafety outcome
In participants with diabetes and atherosclerotic cardiovascular disease, vomiting was less common with dulaglutide than tirzepatide.
In plain wordsIn people with diabetes and artery disease, vomiting occurred less often with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseVomiting
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452018
08HumanRandomized controlled trialSafety outcome
In participants with diabetes and atherosclerotic cardiovascular disease, diarrhoea was less common with dulaglutide than tirzepatide.
In plain wordsIn people with diabetes and artery disease, diarrhea occurred less often with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseDiarrhoea
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452019
09HumanRandomized controlled trialEfficacy outcome
In participants with low-to-moderate-risk chronic kidney disease, composite kidney event risk was higher with dulaglutide than tirzepatide.
In plain wordsIn participants with lower-risk kidney disease, dulaglutide had more combined kidney events than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseComposite kidney outcome in low-to-moderate-risk CKD
Study
n: not reported in source
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Kidney function · Kidney and urinary
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Measurements
patients with primary composite kidney outcome, dulaglutide
283 events
dulaglutide 1·5 mg, low-to-moderate-risk CKD
proportion with primary composite kidney outcome, dulaglutide
5.6%
dulaglutide 1·5 mg, low-to-moderate-risk CKD
patients with primary composite kidney outcome, tirzepatide
195 events
tirzepatide up to 15 mg, low-to-moderate-risk CKD
proportion with primary composite kidney outcome, tirzepatide
4%
tirzepatide up to 15 mg, low-to-moderate-risk CKD
hazard ratio, primary composite kidney outcome
0.7 HR
tirzepatide versus dulaglutide, low-to-moderate-risk CKD
95% CI of hazard ratio
0.58 to 0.84 HR
tirzepatide versus dulaglutide, low-to-moderate-risk CKD
Source sentences
Summary
and was similarly reduced in those with low-to-moderate-risk chronic kidney disease (195 [4·0%] vs 283 [5·6%], 0·70 [0·58 to 0·84], p=0·0001)
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452012
10HumanRandomized controlled trialEfficacy outcome
In participants with high-risk chronic kidney disease, composite kidney event risk was higher with dulaglutide than tirzepatide.
In plain wordsIn participants with high-risk kidney disease, dulaglutide had more combined kidney events than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseComposite kidney outcome in high-risk CKD
Study
n: not reported in source
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Kidney function · Kidney and urinary
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Measurements
patients with primary composite kidney outcome, dulaglutide
203 events
dulaglutide 1·5 mg, high-risk CKD
proportion with primary composite kidney outcome, dulaglutide
14.5%
dulaglutide 1·5 mg, high-risk CKD
patients with primary composite kidney outcome, tirzepatide
185 events
tirzepatide up to 15 mg, high-risk CKD
proportion with primary composite kidney outcome, tirzepatide
12.2%
tirzepatide up to 15 mg, high-risk CKD
hazard ratio, primary composite kidney outcome
0.79 HR
tirzepatide versus dulaglutide, high-risk CKD
95% CI of hazard ratio
0.64 to 0.96 HR
tirzepatide versus dulaglutide, high-risk CKD
Source sentences
Summary
and those with high-risk chronic kidney disease (185 [12·2%] vs 203 [14·5%], 0·79 [95% CI 0·64 to 0·96], p=0·018).
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452013
11HumanRandomized controlled trialEfficacy outcome
In participants with low-to-moderate-risk chronic kidney disease, new-onset persistent macroalbuminuria was more frequent with dulaglutide than tirzepatide.
In plain wordsIn participants with lower-risk kidney disease, dulaglutide had more new persistent high urine protein levels than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseNew-onset persistent macroalbuminuria in low-to-moderate-risk CKD
Study
n: not reported in source
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Kidney function · Kidney and urinary
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
This was primarily driven by a lower rate of new-onset persistent macroalbuminuria in those with low-to-moderate-risk chronic kidney disease and a lower rate of eGFR decline in those with high-risk chronic kidney disease.
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452014
12HumanRandomized controlled trialEfficacy outcome
In participants with high-risk chronic kidney disease, eGFR decline was greater with dulaglutide than tirzepatide.
In plain wordsIn participants with high-risk kidney disease, kidney filtration declined faster with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseAnnual eGFR decline in high-risk CKD
Study
n: not reported in source
Comparator
Tirzepatide up to 15 mg
Analysis
Exploratory
Outcome group
Kidney function · Kidney and urinary
Studied dose
1·5 mg weekly · subcutaneousAs given in this study (human).
Measurements
between-group difference in annual eGFR decline
0.93 mL/min per 1·73 m2
tirzepatide versus dulaglutide, high-risk CKD
95% CI of difference
0.65 to 1.22 mL/min per 1·73 m2
tirzepatide versus dulaglutide, high-risk CKD
Source sentences
Summary
The annual rate of decline in eGFR was lower with tirzepatide than with dulaglutide in the overall population (between-group difference 0·29 mL/min per 1·73 m² [95% CI 0·17 to 0·41]; p2 [0·65 to 1·22], p<0·0001).
2 context sentences(design, population, supporting numbers)
Summary · context
SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries.
Summary · context
were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452015
13HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and atherosclerotic cardiovascular disease, the annual rate of eGFR decline was lower with tirzepatide than with dulaglutide.
In plain wordsIn people with type 2 diabetes and heart disease, kidney filtering fell more slowly each year with tirzepatide than with dulaglutide.
Peptide
Tirzepatide
Outcome
DecreaseAnnual rate of eGFR decline, overall population
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Measurements
Between-group difference in annual eGFR decline
0.29 mL/min per 1.73 m2
overall population
Source sentences
Summary
The annual rate of decline in eGFR was lower with tirzepatide than with dulaglutide in the overall population (between-group difference 0·29 mL/min per 1·73 m² [95% CI 0·17 to 0·41]; p<0·0001)
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452006
14HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and low-to-moderate-risk chronic kidney disease, tirzepatide gave a lower rate of new-onset persistent macroalbuminuria than dulaglutide.
In plain wordsIn people with type 2 diabetes and low-to-moderate kidney disease risk, tirzepatide led to fewer cases of new heavy protein loss in urine than dulaglutide.
Peptide
Tirzepatide
Outcome
DecreaseNew-onset persistent macroalbuminuria, low-to-moderate-risk CKD
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Source sentences
Summary
a lower rate of new-onset persistent macroalbuminuria in those with low-to-moderate-risk chronic kidney disease
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452004
15HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and high-risk chronic kidney disease, tirzepatide gave a lower rate of eGFR decline than dulaglutide.
In plain wordsIn people with type 2 diabetes and high-risk kidney disease, tirzepatide slowed the fall in kidney filtering more than dulaglutide.
Peptide
Tirzepatide
Outcome
DecreaseeGFR decline, high-risk CKD (event rate)
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Source sentences
Summary
a lower rate of eGFR decline in those with high-risk chronic kidney disease.
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452005
16HumanRandomized controlled trialEfficacy outcome
In people with type 2 diabetes and high-risk chronic kidney disease, the annual rate of eGFR decline was lower with tirzepatide than with dulaglutide.
In plain wordsIn people with type 2 diabetes and high-risk kidney disease, kidney filtering fell more slowly each year with tirzepatide than with dulaglutide.
Peptide
Tirzepatide
Outcome
DecreaseAnnual rate of eGFR decline, high-risk CKD
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Kidney function · Kidney and urinary
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Measurements
Between-group difference in annual eGFR decline
0.93 mL/min per 1.73 m2
high-risk CKD
Source sentences
Summary
The annual rate of decline in eGFR was lower with tirzepatide than with dulaglutide in the overall population (between-group difference 0·29 mL/min per 1·73 m² [95% CI 0·17 to 0·41]; p2 [0·65 to 1·22], p<0·0001).
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452007
17HumanRandomized controlled trialSafety outcome
In people with type 2 diabetes and atherosclerotic cardiovascular disease, nausea was more common with tirzepatide than with dulaglutide.
In plain wordsIn people with type 2 diabetes and heart disease, nausea was more common with tirzepatide than with dulaglutide.
Peptide
Tirzepatide
Outcome
IncreaseNausea
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Source sentences
Summary
Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452008
18HumanRandomized controlled trialSafety outcome
In people with type 2 diabetes and atherosclerotic cardiovascular disease, vomiting was more common with tirzepatide than with dulaglutide.
In plain wordsIn people with type 2 diabetes and heart disease, vomiting was more common with tirzepatide than with dulaglutide.
Peptide
Tirzepatide
Outcome
IncreaseVomiting
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Source sentences
Summary
Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452009
19HumanRandomized controlled trialSafety outcome
In people with type 2 diabetes and atherosclerotic cardiovascular disease, diarrhoea was more common with tirzepatide than with dulaglutide.
In plain wordsIn people with type 2 diabetes and heart disease, diarrhoea was more common with tirzepatide than with dulaglutide.
Peptide
Tirzepatide
Outcome
IncreaseDiarrhoea
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
up to 15 mg · subcutaneous · median follow-up 4.0 yearsAs given in this study (human).
Source sentences
Summary
Nausea, vomiting, and diarrhoea were all more common in those receiving tirzepatide than in those receiving dulaglutide.
1 context sentence(design, population, supporting numbers)
Summary · context
Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA_1c between 7% and 10·5%, and a BMI of 25 kg/m² or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg.
Show in the study text Report a problemFND-4211452010

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Versions 4 to 8Current
28 Oct 2026, 02:03 UTC
The same notice was added 5 times, first on 22 Oct 2026, 02:26 UTC. The status did not change between them.
Study results updated
Version 3
21 Oct 2026, 18:59 UTC
Study data updated · source update from Europe PMC
Version 2
12 Oct 2026, 12:10 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC

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A comparison of the effects of tirzepatide and dulaglutide on major kidney events in people with type 2 diabetes: pre-specified exploratory analyses of the SURPASS-CVOT trial.

Summary

Results from this study19

Version history

Subjects

Publication types

MeSH terms