Effects of semaglutide on kidney disease in type 2 diabetes: a randomized placebo-controlled trial

Effects of semaglutide on kidney disease in type 2 diabetes

A randomized placebo-controlled trial

Co-authors: Katherine Tuttle, MD and Petter Bjornstad, MD

Chronic kidney disease (CKD) affects nearly 800 million people and develops in 40% of those living with type 2 diabetes (T2D), making diabetes the leading cause of kidney failure worldwide1,2,3,4. In the FLOW (evaluate renal Function with semagLutide Once Weekly) trial, subcutaneous semaglutide 1.0 mg once weekly reduced risk of the primary kidney outcome, defined as ≥50% decline in the estimated glomerular filtration rate (eGFR), kidney failure or death due to kidney or cardiovascular causes, by 24% in participants with T2D and CKD5.

Mechanisms for the kidney-protective effects of semaglutide are unclear. Mediation analyses from clinical trials of glucagon-like peptide (GLP-1) receptor agonists, including semaglutide, indicate that lowering of glycemia and body weight only partly explain the kidney benefit6,7.