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Zepbound kidney lab tracker: eGFR, creatinine and urine albumin

Record kidney results in one place with the context that changes how they read: the Zepbound dose at the time, any vomiting or diarrhea that week, and medicines that affect kidney numbers. A single low eGFR after a bout of dehydration means something different from a steady downward trend.

Companion to “How Zepbound Affects eGFR: Tirzepatide and Kidney Function” · healthrx.com/how-zepbound-affects/egfr · Facts checked 2026-10-18

Starting values

eGFR and date
Creatinine
Urine albumin-to-creatinine ratio (UACR)
Kidney disease stage, if diagnosed
Blood pressure

Medicines that change how kidney results read

  • Anti-inflammatory pain relievers such as ibuprofen or naproxen
  • ACE inhibitor or ARB
  • Diuretic (water pill)
  • Metformin
  • SGLT2 inhibitor
  • Insulin or a sulfonylurea

Results while on Zepbound

DateZepbound dose (mg)eGFRCreatinineUACRVomiting or diarrhea that week?Medicine changesWhat the clinician said

What the label and the kidney analyses say

  • The label recommends no Zepbound dose change for kidney impairment; tirzepatide levels were unchanged even in end-stage kidney disease.[1]
  • Kidney function should be monitored when side effects could cause fluid loss, especially when a dose is started or raised.[1]
  • In the weight trials, acute kidney injury was reported in 0.5% of Zepbound-treated patients and 0.2% on placebo.[1]
  • In SURMOUNT-1 and SURMOUNT-2, urine albumin fell with tirzepatide and eGFR did not worsen.[2]
  • In SURPASS-4, eGFR declined by a mean 1.4 a year on tirzepatide against 3.6 a year on insulin glargine.[3]

Call before the next injection if

  • Vomiting, diarrhea or nausea means you are not keeping fluids down: dehydration can lead to kidney problems.[1]

Questions about your results

  1. Was this result taken during or soon after a bout of vomiting or diarrhea?
  2. Would a cystatin C test or a repeat test help interpret this eGFR?
  3. Should any pain reliever, blood pressure medicine or diuretic be paused while my dose is rising?
  4. What change from my starting value would make you recheck sooner?
  5. Does my metformin or other medicine need review at this eGFR?
Sources for the facts on this sheet
  1. Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
  2. Heerspink HJL, Friedman AN, Bjornstad P, et al. Kidney Parameters with Tirzepatide in Obesity with or without Type 2 Diabetes. J Am Soc Nephrol 2025. PMID 40512543. https://pubmed.ncbi.nlm.nih.gov/40512543/
  3. Heerspink HJL, Sattar N, Pavo I, et al. Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: post-hoc analysis of an open-label, randomised, phase 3 trial. Lancet Diabetes Endocrinol 2022. PMID 36152639. https://pubmed.ncbi.nlm.nih.gov/36152639/

This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.