About

Srinivasan Beddhu, MD, is a Professor and the Dialysis Research Foundation Presidential Endowed Chair of Internal Medicine at the University of Utah School of Medicine. He is a principal investigator in the Nephrology & Hypertension Research division, contributing to research in internal medicine with a focus on nephrology and dialysis. His role involves leading research projects, mentoring graduate students and postdoctoral researchers, and collaborating with a team of faculty, statisticians, and research staff to advance understanding and treatment of kidney-related health issues.

Research topics

• Internal medicine
• Medicine
• Endocrinology
• Intensive care medicine
• Cardiology
• Radiology
• Pediatrics
• Emergency medicine
• Surgery
• Pathology
• Physical therapy
• Psychiatry

Selected publications

• Impact of automatic e-consults on use of SGLT2i and GLP-1 RA in rural veterans with type 2 diabetes and chronic kidney disease

  Primary care diabetes · 2026-04-10

  articleOpen accessSenior author

  In this pilot study, we identified rural veterans with chronic kidney disease and type 2 diabetes who have an indication for SGLT2i or GLP-1 RA but not yet on either of these agents. Nearly a third of providers changed their practice based on automatic e-consult; however, there were still 69% of cases where providers did not.

  PublisherOA PDFDOI

• Cardiorenal Syndrome and Depressive Symptoms: Exploring the Mood-Kidney Link With Heart Failure Risk in a Post-hoc Analysis of SPRINT

  Kidney Medicine · 2026-05-01

  articleOpen accessSenior author
  PublisherDOI

• Comparative Effectiveness of SGLT2 Inhibitor and GLP-1 Receptor Agonist on Kidney and Cardiovascular Outcomes by Kidney Failure Risk

  Journal of the American Society of Nephrology · 2026-01-13 · 1 citations

  articleOpen accessSenior author

  KEY POINTS: In veterans with type 2 diabetes and low kidney failure risk, sodium-glucose cotransporter 2 inhibitors (SGLT2is) were more kidney protective while glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were more cardioprotective. For cardiovascular-kidney-metabolic outcomes, GLP-1 RAs were more protective at moderate kidney failure risk and SGLT2is were more protective at high kidney failure risk. The kidney failure risk equation might be a clinically useful tool to guide therapy in type 2 diabetes. BACKGROUND: Head-to-head comparisons of non-exendin glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) on kidney failure or cardiovascular-kidney-metabolic (CKM) composite end points are lacking. Whether kidney failure risk modifies the comparative effectiveness of GLP-1 RA versus SGLT2i is clinically relevant. METHODS: We defined a national veterans cohort with type 2 diabetes who initiated an SGLT2i, non-exendin GLP-1 RA, or insulin glargine between January 1, 2018, and December 31, 2021. After applying inverse probability of treatment weighting to balance baseline characteristics, outcomes were compared across new-user groups through March 31, 2023. Outcomes included kidney failure (stage 5 CKD or long-term KRT), major adverse cardiovascular events (MACEs: heart failure, myocardial infarction, or stroke), CKM composite (kidney failure or MACE), all-cause death, and composites of outcomes with death. We tested for effect modification by the kidney failure risk equation (KFRE) score on comparative pairwise drug effectiveness. RESULTS: Out of 160,428 veterans, 53%, 14%, and 34% were new users of SGLT2i, GLP-1 RA, and insulin glargine, respectively. Relative to GLP-1 RA new-users, SGLT2i new-users had similar mortality risk, a trend toward lower kidney failure risk (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.74 to 1.06), but higher risk of MACE (HR, 1.14; 95% CI, 1.09 to 1.20) and CKM composite (HR, 1.13; 95% CI, 1.08 to 1.19). The effect of SGLT2i versus GLP-1 RA differed significantly between moderate-risk (2%-6%) and high-risk (≥6%) KFRE subgroups for all outcomes except all-cause death. In those with moderate-risk KFRE, GLP-1 RA seemed more protective for kidney failure, MACE, and CKM composite, while SGLT2i appeared more protective in those with high-risk KFRE. CONCLUSIONS: Compared with GLP-1 RA, SGLT2i had comparable risks of mortality, perhaps a lower risk of kidney failure, but modestly higher risk of cardiovascular events in the entire cohort. However, GLP-1 RA were more beneficial in those with moderate kidney failure risk and SGLT2i more beneficial in those with high kidney failure risk.

  PublisherOA PDFDOI

• Comparative effectiveness of insulin glargine, glucagon‐like peptide‐1 receptor agonists and <scp>sodium‐glucose cotransporter‐2 inhibitors</scp> in veterans with type 2 diabetes

  Diabetes Obesity and Metabolism · 2025-01-30 · 2 citations

  articleOpen accessSenior authorCorresponding

  AIMS: To compare the risk of all-cause death and cardiovascular events in new users of insulin glargine, glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), particularly in subgroups defined by baseline haemoglobin A1C (HbA1C), body mass index (BMI) and estimated glomerular filtration rate (eGFR). MATERIALS AND METHODS: We conducted an active comparator, new user design study in a national cohort of 161 405 veterans with type 2 diabetes (T2D) on metformin and initiated insulin glargine (n = 54 375), GLP-1RA (n = 22 145) or SGLT2i (n = 84 885) between 1 January 2018 and 31 December 2021. Patients were followed until 31 March 2023. Inverse probability weighted Cox regression models were used for treatment comparisons on all-cause deaths and cardiovascular events in the entire cohort and above subgroups. RESULTS: There were 20 788 cardiovascular events/414 414 person-years and 15 268 all-cause deaths/446 458 person-years. Insulin glargine had a higher hazard of all-cause death compared to GLP-1RA (hazard ratio [HR] 1.57, 95% confidence interval [CI] 1.48-1.67) or SGLT2i (HR 1.55, 95% CI 1.48-1.61) in the entire cohort and across subgroups, especially in those with HbA1C levels <9.0%. Results were similar for secondary outcomes. Compared to GLP-1RA, SGLT2i had similar risk of all-cause death (HR 1.03, 95% CI 0.97-1.10) but higher hazard of cardiovascular events (HR 1.13, 95% CI 1.08-1.19). Across subgroups, GLP-1RA and SGLT2i had generally similar effects, with SGLT2i showing a slightly higher risk in some cases. CONCLUSIONS: Insulin glargine might be deleterious particularly in those with HbA1C <9.0%. There was no clear evidence for prioritization of SGLT2i versus GLP-1RA across subgroups.

  PublisherOA PDFDOI

• Associations of Plasma Ceramides with Adipose Tissue, Plasma, and Urinary Markers of Inflammation and Oxidative Stress in CKD

  Journal of the American Society of Nephrology · 2025-10-01

  article
  PublisherDOI

• Kidney Failure Risk Modifies Comparative Effectiveness of SGLT2 Inhibitors and GLP-1 Receptor Agonists on Cardiovascular-Kidney-Metabolic (CKM) Events

  Journal of the American Society of Nephrology · 2025-10-01

  articleSenior author
  PublisherDOI

• Impact of SGLT2 Inhibitors and GLP-1 Receptor Agonists on Kidney Failure Risk Prediction

  Journal of the American Society of Nephrology · 2025-10-01

  articleSenior author
  PublisherDOI

• BPROAD — End of the Road for Debate on Systolic Blood-Pressure Goals in Type 2 Diabetes?

  New England Journal of Medicine · 2025-03-26

  editorialSenior author
  PublisherDOI

• Liraglutide vs Semaglutide vs Dulaglutide in Veterans With Type 2 Diabetes

  JAMA Network Open · 2025-10-13 · 5 citations

  articleOpen accessSenior authorCorresponding

  Importance: The head-to-head comparative effectiveness and safety of individual glucagon-like peptide-1 receptor agonists (GLP-1RAs) are not well understood. Objective: To compare risks of kidney, cardiovascular, and death outcomes among patients with type 2 diabetes initiating GLP-1RAs in the Department of Veterans Affairs (VA) health system. Design, Setting, and Participants: This comparative effectiveness study used an active-comparator, new-user target trial-emulation design with national data linked among the VA, Medicare, and US Renal Data System. Participants were GLP-1RA-naive veterans with type 2 diabetes and without end-stage kidney disease treated with metformin who started liraglutide, semaglutide, or dulaglutide between January 1, 2018, and December 31, 2021. Data were analyzed from September 2024 to June 2025. Exposure: Liraglutide, semaglutide, or dulaglutide. Main Outcomes and Measures: Kidney failure (sustained estimated glomerular filtration rate <15 mL/min/1.73 m2 or initiation of kidney replacement therapy), composite cardiovascular and kidney metabolic (CKM) events (kidney failure or major adverse cardiovascular events [MACE]; myocardial infarction, heart failure, or stroke/transient ischemic attack), MACE, all-cause death, and adverse gastrointestinal events (gastroparesis, intestinal obstruction, gallstones, acute cholecystitis, acute pancreatitis) were evaluated separately through March 31, 2023. Results: Of 21 790 included veterans (mean [SD] age, 63.5 [10.8] years, 19 823 [91.0%] male), 5425 (24.9%), 10 838 (49.7%), and 5527 (24.9%) initiated liraglutide, semaglutide, and dulaglutide, respectively. In weighted Cox regression models, compared with initiation of semaglutide, liraglutide initiation had similar hazards for kidney failure (hazard ratio [HR], 0.93; 95% CI, 0.60-1.44), the CKM composite outcome (HR, 0.96; 95% CI, 0.84-1.10), and MACE (HR, 0.95; 95% CI, 0.83-1.09). Results were similar with liraglutide vs dulaglutide and dulaglutide vs semaglutide comparisons. Liraglutide had significantly lower hazard of all-cause death compared with semaglutide under intent-to-treat analyses (HR, 0.83; 95% CI, 0.69-0.99), which lost significance in per-protocol models. Compared with dulaglutide, liraglutide was associated with a lower risk of all-cause mortality in both the intent-to-treat (HR, 0.69; 95% CI, 0.58-0.83) and per-protocol (HR, 0.50; 95% CI, 0.31-0.82) analyses, but compared with semaglutide, dulaglutide had higher hazard of mortality only in the per-protocol model (HR, 1.72; 95% CI, 1.20-2.47). The only observed difference for the gastrointestinal adverse events was a decreased risk for gallstones and acute cholecystitis with dulaglutide vs semaglutide (gallstones: HR, 0.72; 95% CI, 0.54-0.95; acute cholecystitis: HR, 0.62; 95% CI, 0.39-0.99). Conclusions and Relevance: In this comparative effectiveness study in veterans with diabetes, liraglutide, semaglutide, and dulaglutide initiators had similar risks for kidney and cardiovascular outcomes. Head-to-head randomized trials are needed to confirm these findings.

  PublisherOA PDFDOI

• Glycemic therapies and the risk of gastrointestinal adverse events in veterans with type 2 diabetes

  Diabetes Obesity and Metabolism · 2025-07-30 · 5 citations

  articleOpen accessSenior authorCorresponding

  AIMS: To compare the risk of gastrointestinal adverse events in new users of glucagon-like peptide-1 receptor agonists (GLP-1RA), sodium-glucose cotransporter-2 inhibitors (SGLT2i) and insulin glargine. MATERIALS AND METHODS: We conducted an active comparator, new user design study in veterans with type 2 diabetes who initiated one of these drug classes between 1 January 2018 and 31 December 2021 (N = 141 080). Inverse probability weighted Cox regression models were used to relate drug class to outcomes of gastroparesis, intestinal obstruction, gallstones, acute cholecystitis, acute pancreatitis and all-cause death. RESULTS: There were 19 765 (14.0%) veterans initiated on GLP-1RA, 75 058 (53.2%) on SGLT2i and 46 257 (32.8%) on insulin glargine. Compared to SGLT2i, GLP-1RA had a higher hazard of gastroparesis (HR 1.65, 95% CI 1.33-2.05) but a similar mortality hazard. Compared to insulin glargine, GLP-1RA had a higher hazard of gastroparesis (HR 1.24, 95% CI 1.02, 1.52), but a lower hazard of all-cause death (HR 0.62, 95% CI 0.58, 0.66). Compared to SGLT2i, insulin glargine had a higher hazard of gastroparesis (HR 1.29, 95% CI 1.07, 1.56), intestinal obstruction (HR 1.26, 95% CI 1.11, 1.43) and all-cause death (HR 1.58, 95% CI 1.50, 1.65). Risks of gallstones, acute cholecystitis and pancreatitis were similar across the classes. CONCLUSIONS: In patients with type 2 diabetes at risk for gastroparesis, SGLT2i might be the preferred agent. In patients for whom SGLT2i is not an option or another agent is needed, patients and providers might need to weigh the higher risk of death with insulin glargine against the higher risk of gastroparesis with GLP-1RA.

  PublisherOA PDFDOI

Recent grants

• NIH Grant R01DK077298

  NIH · $1.4M · 2013

• NIH Grant R01DK091437

  NIH · $2.3M · 2018

• Sit Less, Interact, Move More (SLIMM) intervention for sedentary behavior in CKD

  NIH · $416k · 2016–2019

• NIH Grant R01DK078112

  NIH · $2.2M · 2013

• Long-term metabolic effects of kidney events with intensive SBP control

  NIH · $1.2M · 2018–2023

Frequent coauthors

• Daniel E. Weiner

  Tufts Medical Center

  1476 shared

• Dan R. Berlowitz

  999 shared

• Addison A. Taylor

  Virginia Commonwealth University

  991 shared

• Clive Rosendorff

  Sprint (United States)

  983 shared

• Peter Van Buren

  The University of Texas Southwestern Medical Center

  980 shared

• R. Nick Bryan

  University of Pennsylvania

  976 shared

• Alfred K. Cheung

  University of Utah

  711 shared

• Wei Guo

  ShenZhen People’s Hospital

  531 shared

Labs

• Beddhu LabPI

Awards & honors

• Dialysis Research Foundation Presidential Endowed Chair in t…