Tirzepatide as a therapeutic tool for kidney impairment in obesity: insights from a real-world study

In 36 adults with overweight or obesity, three months of tirzepatide treatment was associated with improved kidney function — serum creatinine fell and estimated GFR rose — while body weight, glycaemic/insulin measures and hs-CRP also improved. Weight loss, measured as change in BMI, was the main predictor of the eGFR improvement. The study is small, short and uncontrolled, so it only suggests an association.

Journal article — Retrospective real-world study. Population: Adults with overweight (BMI ≥ 27 kg/m² with comorbidity) or obesity (BMI ≥ 30 kg/m²) in an outpatient setting. Sample size: 36 adults. Follow-up: 3 months. Interventions: tirzepatide weekly 2.5-5 mg.

After 3 months, serum creatinine decreased (p < 0.001) and eGFR increased (p < 0.001). Body weight, BMI and waist circumference decreased (p < 0.001). Fasting glucose and insulin decreased (p < 0.001), as did HOMA-IR (p < 0.001); HbA1c decreased (p = 0.002). hs-CRP decreased (p < 0.001). In correlation analysis, ΔeGFR was inversely associated with Δweight loss (p = 0.008), ΔBMI (p = 0.007) and Δfasting insulin (p = 0.011), positively with fasting plasma glucose (p < 0.001), and borderline inversely with ΔHOMA-IR (p = 0.053); in regression, ΔBMI explained 19.4% of the variance in ΔeGFR (p = 0.007).

Researchers studying tirzepatide will care about this paper because it provides real-world evidence linking tirzepatide treatment with improved eGFR and reduced serum creatinine in obesity, with weight loss as the main predictor of the improvement. It does not establish a causal kidney-protective effect, because it is small, short, uncontrolled, and did not assess hard renal outcomes such as albuminuria or progression to kidney failure.

Key findings

• After 3 months of weekly tirzepatide, serum creatinine decreased significantly (p < 0.001) and eGFR increased significantly (p < 0.001).
• Body weight, BMI and waist circumference all decreased (p < 0.001) after 3 months.
• Fasting plasma glucose and insulin decreased (p < 0.001), HOMA-IR decreased (p < 0.001), and HbA1c decreased (p = 0.002).
• hs-CRP decreased after 3 months (p < 0.001).
• ΔeGFR was inversely associated with Δweight loss (p = 0.008), ΔBMI (p = 0.007) and Δfasting insulin (p = 0.011), and positively with fasting plasma glucose (p < 0.001); ΔBMI predicted ΔeGFR, explaining 19.4% of variance (p = 0.007).

Limitations

• Retrospective observational design cannot establish causality.
• No control or comparator group.
• Small sample size (n = 36) and short 3-month follow-up.
• Real-world observational data are subject to residual confounding.

The record

• Journal: Journal of translational medicine
• Published: 2026-07-16
• PMID: 42464302 — DOI: 10.1186/s12967-026-08558-4
• Author countries: Italy, USA

Peptide profiles: Tirzepatide.

All indexed evidence: Tirzepatide trials & papers.

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