An oral pill that mimics GLP-1 cut the amount of protein leaking into the urine by about a third in people with diabetic kidney disease, and it did so on top of the two newest kidney-protecting drugs.
The drug is HRS-7535, a once-daily glucagon-like peptide-1 receptor agonist from Jiangsu Hengrui Pharmaceuticals. Unlike semaglutide and the other injectable GLP-1 drugs, it is a small-molecule pill built around an ordinary chemical rather than a protein. That is what lets it survive the gut and be swallowed. In a Phase 2 trial called SOLID-DKD, published in EClinicalMedicine ↗, 280 adults in China with diabetic kidney disease took 30 mg or 90 mg of HRS-7535 or a placebo once a day for 16 weeks.
The number that matters here is albuminuria, the amount of the blood protein albumin spilling into the urine. It is measured as the urine albumin-to-creatinine ratio, or UACR, and a higher figure means more kidney damage. Everyone in the trial started high, with a median UACR of 763 (a healthy kidney keeps it under 30). At the 90 mg dose, UACR fell 32 percent further than on placebo (95 percent confidence interval 18 to 43 percent). It fell 38 percent in the analysis limited to people who stayed on the drug. The lower 30 mg dose brought it down about 14 percent, a smaller drop that did not clearly separate from placebo in the main analysis.
Why the background therapy is the story
The result would be unremarkable if these patients were untreated. They were not. Nearly two in three (64.6 percent) were already taking an SGLT2 inhibitor, and one in four (24.3 percent) were on finerenone. Those are the two drug classes added to the kidney-disease playbook in the last few years, both proven in outcome trials to slow the disease. HRS-7535 cut albuminuria further on top of them.
That is the signal drug developers look for. Albuminuria is one of the few kidney markers that moves early and tracks with how fast the disease will progress, so bringing it down even when the best current drugs are already on board is the usual green light for a larger trial. The authors write that the finding supports moving HRS-7535 into Phase 3 renal outcome trials ↗.
The pill also did the ordinary GLP-1 things. HbA1c, a three-month average of blood sugar, fell about 1.1 percentage points more than placebo at the high dose, and body weight dropped about 3 percent. Side effects were mostly mild-to-moderate nausea and other gut complaints during the dose ramp, the familiar GLP-1 pattern. Serious adverse events were uncommon and roughly balanced (4.3 percent on 90 mg, 2.2 percent on placebo), and no one died.
The caveats worth keeping
This is 16 weeks, not years, and albuminuria is a stand-in, not the outcome patients care about. A drop in urine protein is a strong bet on slower kidney decline, but it is not the same as proving that fewer people reach dialysis. That is what a Phase 3 renal outcome trial has to demonstrate, and those run for years. The study was also conducted entirely in China and funded by the company that makes the drug.
The injectable GLP-1 class has already shown it can slow kidney disease in large outcome trials, which is part of why an oral version reaching for the same benefit is worth watching. HRS-7535 is the same molecule we covered in June ↗ at higher doses for weight loss, where more drug was not always better. Over the narrow 30-to-90 mg range tested here, more was more: the higher dose cut albuminuria more than the lower one.
Peptidemodel hosts the semaglutide card ↗ as the reference injectable in the GLP-1 receptor ↗ class. HRS-7535, still unapproved and not a peptide, does not have a card yet.