Comparison of the Efficacy and Safety of SGLT2i and GLP-1 Receptor Agonists in Obese Patients With Kidney Disease

Inclusion Criteria: 1. Agree to join this study and sign an informed consent form; 2. Age ≥ 18 years old and\<75 years old; 3. BMI ≥ 25kg/m ² Or waist circumference ≥ 85cm (male)/≥ 80cm (female) or waist to hip ratio ≥ 0.9 (male)/≥ 0.85 (female); 4. Confirmed obesity related kidney disease through renal biopsy within six months; 5. Have received optimized treatment with RAS blockers and/or MRA for at least 3 months; Exclusion Criteria: 1. Diagnosed as secondary obesity, such as hypothyroidism, Cushing's syndrome, polycystic ovary syndrome, etc; 2. Severe renal insufficiency (renal function eGFR\<25 ml/min/1.73m2); 3. There is acute kidney injury; Defined as: (1) An increase in blood creatinine of ≥ 26.5 within 48 hours μ Mol/L; (2) Within 7 days, the increase in blood creatinine exceeds 1.5 times the baseline value or more; (3) Reduced urine output (\<0.5 ml/kg/h) and lasting for more than 6 hours. 4. Symptoms of active reproductive and urinary system infections 5. Severe liver dysfunction (ALT/AST greater than 2.5 times the upper normal limit); 6. Severe cardiovascular and cerebrovascular diseases, rheumatic and immune diseases; 7. Serious metabolic diseases, such as diabetes ketoacidosis, hypertonic hyperglycemia, etc; 8. Late stage malignant tumors; 9. Have a known history of using drugs that affect glucose and lipid metabolism, such as glucocorticoids, antibiotics, anti anxiety or antidepressants, etc; 10. Severe bleeding tendency and inability to complete venous blood collection; 11. There are contraindications for MRI examination, such as patients with pacemakers, nerve stimulators, artificial metal heart valves, etc; Patients with claustrophobia; Epilepsy patients, etc. 12. Pregnant/lactating women;