Effects of liraglutide on blood pressure and renal function in patients with type 2 diabetic nephropathy: a meta-analysis of randomized controlled trials

Objectives The effects of liraglutide on blood pressure in patients with T2DN remain unclear. This meta-analysis aimed to systematically evaluate the effects of liraglutide on blood pressure and renal function in patients with T2DN. Methods We conducted comprehensive searches of Web of Science, PubMed, the Cochrane Library, Elsevier ScienceDirect, CNKI, Wanfang Data, and VIP databases. Eligible studies were RCTs of ≥12 weeks’ duration evaluating liraglutide for T2DN. Two independent reviewers screened citations, extracted data, and assessed methodological quality using the Cochrane Risk-of-Bias Tool. Statistical analyses were performed in Stata 17.0 and RevMan 5.4, with effect sizes presented as RR or MD and 95% CI. The Cochrane Q test and I 2 statistic were used to quantify statistical heterogeneity. Results This meta-analysis included 23 RCTs involving 1,723 participants. Compared with the control group, liraglutide significantly reduced SBP [MD = −5.00, 95% CI (−7.17, −2.84)], while no significant effect was observed on DBP. In addition, liraglutide was associated with favorable changes in some renal biomarkers, as evidenced by reductions in Scr, UACR, Cys-C, BUN, and β 2-MG, as well as elevations in eGFR. Improvements were also observed in glycemic control, lipid profiles, BMI, and inflammatory markers. Subgroup analyses indicated dose-dependent differences in UACR and LDL-C. In addition, both UACR and Scr were affected by intervention-regimen type, while HbA1c was affected by baseline albuminuria category. Sensitivity analyses confirmed the robustness of the findings, and adjustment for publication bias did not alter the statistical significance of the key outcomes. Conclusion Liraglutide may be associated with favorable changes in selected BP, renal, metabolic, and inflammatory outcomes in patients with T2DN. However, further high-quality studies are needed to confirm these findings. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251232844 , PROSPERO CRD420251232844.