What a 24-week, 146-person trial found, and what it didn't.
The short version
TRANSCEND-CKD tested weekly retatrutide against placebo for 24 weeks in 146 adults with overweight or obesity and chronic kidney disease, with or without type 2 diabetes. [1][2]
- Kidney filtration, measured directly, did not change versus placebo. This was the main goal of the trial. [1][2]
- Urine albumin (a marker of kidney strain) fell in people who started with high levels. [1][2]
- Weight and systolic blood pressure fell. Pulse rose. [1][2]
The researchers say this pattern suggests a possible long-term kidney-protective effect. The trial was too small and too short to show that. [2]
Who was in the trial
- 146 adults: 75 on retatrutide, 71 on placebo. [2]
- BMI of 27 or higher, with established chronic kidney disease (cystatin C–based eGFR 25 to 75 mL/min/1.73 m²). [2]
- About 30% started with elevated urine albumin (UACR ≥30 mg/g). [2]
- Phase 2b, sponsored by Eli Lilly. Presented at ASN Kidney Week 2026 in Denver as poster TH-PO1238. [1][2]
Results at 24 weeks
| Measure | Retatrutide | Placebo | Difference (95% CI) |
|---|---|---|---|
| Measured GFR (iohexol), primary endpoint | −1.6 | −0.2 | −1.4 mL/min/1.73 m² (−9.2 to 6.3), no significant difference |
| UACR, people starting at ≥30 mg/g | −53.7% | −8.8% | −49.2% (−70.6% to −12.3%) |
| Body weight | −14.0 kg | no change | −14.0 kg (−16.0 to −12.0) |
| Systolic blood pressure | −14.0 mmHg | −1.0 mmHg | −13.0 mmHg (−17.2 to −8.9) |
| Estimated intraglomerular pressure | −3.2 mmHg | −0.4 mmHg | −2.8 mmHg (−5.3 to −0.3) |
| Perirenal fat volume | −16.1% | −2.7% | −13.4% (−18.4% to −8.5%) |
| Pulse rate | rose | — | +9.0 bpm (5.7 to 12.3) |
Source for all rows: [1], as reported in [2].
What it doesn't show
- No change in measured kidney filtration. The primary endpoint, measured GFR, showed no difference from placebo. Estimated GFR did rise, but estimates can shift with body composition, which is why the trial measured GFR directly. [2]
- The 54% figure is a subgroup. The drop in urine albumin applies to people who started with elevated levels, about 30% of the trial, not everyone. [2]
- Pulse went up about 9 beats per minute versus placebo. [2]
- No kidney outcomes. 24 weeks and 146 people can't show whether kidney failure or dialysis is delayed. Lilly's larger cardiovascular and kidney outcomes trial is still running. [3]
- Not a treatment recommendation. Retatrutide is not approved for anyone, for any condition. [3]
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Sources
- Heerspink HJL, Botros FT, Hurt KC, et al. Effects of retatrutide on kidney parameters in participants with obesity or overweight and chronic kidney disease. ASN Kidney Week 2026, Denver, CO. Poster TH-PO1238. https://www.asn-online.org/education/kidneyweek/2026/program-abstract.aspx?controlId=4591528
- Brooks A. Retatrutide Lowers Albuminuria, Glomerular Pressure in Obesity and CKD. HCPLive, Oct 22, 2026. https://www.hcplive.com/view/retatrutide-lowers-albuminuria-glomerular-pressure-in-obesity-and-ckd
- Eli Lilly. What to know about retatrutide (updated Sept 2026). https://www.lilly.com/news/stories/what-to-know-about-retatrutide
Disclaimer
Retatrutide is an investigational drug. It is not approved by the FDA or any other regulator. This page is for education only. It is not medical advice and does not give dosing guidance. Talk to a licensed clinician about any treatment.