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Key Findings 1 Tirzepatide reduced major kidney events by 23% vs dulaglutide Events: 6.0% vs 7.6% HR 0.77 (95% CI 0.680.88), p=0.0002 The risk of the primary composite kidney outcomewas 23% lower with tirzepatide than with dulaglutide. 2 Benefits were consistent across CKD risk categories Lowtomoderate risk CKD: HR 0.70 Highrisk CKD: HR 0.79 3 Mechanistic drivers differed by CKD stage Lowtomoderate CKD: Less newonset macroalbuminuria Highrisk CKD: Slower eGFR decline This was primarily driven by a lower rate of new-onset persistent macroalbuminuria and a lower rate of eGFR decline. 4 eGFR decline was significantly slower with tirzepatide Overall difference: +0.29 mL/min/1.73 m per year Highrisk CKD: +0.93 mL/min/1.73 m per year 5 Albuminuria improved more with tirzepatide At 36 months, UACR reductions were greater across CKD categories

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