Introduction <p>Obesity and diabetes are established risk factors for renal function decline. While medical and surgical weight loss therapies have demonstrated reno-protective effects, the impact of endoscopic bariatric and metabolic therapies (EBMTs) on renal function remains unknown.</p> Methods <p>A retrospective observational study was conducted in consecutive adult patients with impaired glycemic control and CKD who underwent EBMTs (primary and revision procedures) at a tertiary care center. The primary outcome was the change in estimated glomerular filtration rate (eGFR) at 12 months. Secondary outcomes included percent total weight loss (%TWL), the proportion of patients achieving ≥5% and ≥10% TWL, change in hemoglobin A1 C (HbA1C), and severe adverse event (SAE) rate. Pre- and post-intervention outcomes were compared using paired t-tests and Wilcoxon signed-rank tests. Linear regression analysis was performed to identify predictors of change in eGFR following EBMTs.</p> Results <p>Mean age and BMI were 56 ± 12 years and 40.0 ± 7.5&#xa0;kg/m², respectively (<i>n</i> = 70). At 12-months, the change in eGFR was not significant, increasing from 71.5 ± 13.6&#xa0;ml/min/1.73m² to 73.2 ± 17.6&#xa0;ml/min/1.73m² (Δ1.1 ± 11.5&#xa0;ml/min/1.73m², <i>p</i> = 0.53), and HbA1C significantly decreased by -0.5 ± 1.2% (<i>p</i> = 0.01). Mean %TWL was 13.4 ± 9.9%. A ≥5% TWL and ≥10% TWL were achieved in 70.0% and 51.4% of patients, respectively. On linear regression analysis, ≥10% TWL was associated with significant improvement in eGFR adjusting for age, sex, baseline BMI, diabetes status, CKD stage, and GLP-1RA use (β = 5.8, 95% CI: 0.4–11.2, <i>p</i> = 0.04). The SAE rate was 1.43%.</p> Conclusion <p>EBMTs appear to stabilize kidney function in patients with impaired glycemic control and CKD, with ≥10% TWL associated with significant improvement in eGFR.</p>