A total of 21.8% of participants were treated with sodium-glucose cotransporter-2 inhibitors at baseline.<h4>Conclusions</h4>TRANSCEND-CKD is designed to provide mechanistic insights on the effects of retatrutide on kidney function and structure, and to inform clinical findings in the ongoing cardio-kidney outcome trial TRIUMPH-Outcomes (NCT06383390).<h4>Clinical trial registration number</h4>NCT05936151. Here, SLC5A2 is linked to chronic kidney disease.