This cohort study assesses whether treatment with glucagon-like peptide-1 (GLP-1) receptor agonists is associated with better outcomes than treatment with dipeptidyl peptidase-4 (DPP-4) inhibitors among patients with type 2 diabetes and advanced-stage chronic kidney disease (CKD) or end-stage kidney disease. The gene discussed is DPP4; the disease is type 2 diabetes mellitus.