Semaglutide Shows Boost in Kidney Health in Obese Patients

(HealthDay News) — Once-weekly subcutaneous semaglutide shows a benefit for kidney outcomes in people with overweight or obesity and established cardiovascular disease, according to a study presented at the annual European Renal Association Congress, held from May 23 to 26 in Stockholm.

Helen M. Colhoun, M.D., from the University of Edinburgh in the United Kingdom, and colleagues conducted a secondary and exploratory analysis on kidney outcomes among participants in the SELECT trial. The analysis included people with overweight or obesity without diabetes (8,803 participants randomly assigned to semaglutide and 8,801 to placebo) followed for a median of 182 weeks.

The researchers found that the main composite nephropathy end point (death from kidney causes; initiation of chronic kidney replacement therapy; onset of persistent estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2; persistent ≥50 percent reduction in eGFR versus baseline; or onset of persistent macroalbuminuria) occurred in fewer of those assigned semaglutide (1.8 versus 2.2 percent with placebo; hazard ratio, 0.78). The composite end point was driven by the treatment effect on onset of macroalbuminuria and, to a lesser extent, persistent ≥50 percent reduction in eGFR. At the prespecified 104-week time point, semaglutide was associated with lesser decline in eGFR than placebo, yielding a treatment effect of 0.75 mL/min/1.73 m2. The proportionate increase in urinary albumin-to-creatinine ratio at 104 weeks was less in the semaglutide arm than the placebo arm, yielding a treatment effect of –10.7 percent. There was no association seen between semaglutide and excess acute kidney injury, regardless of baseline eGFR.

“By addressing key markers of kidney health, semaglutide 2.4 mg weekly may contribute to a significant reduction in the risk of kidney-related complications, including chronic kidney disease and end-stage renal disease,” Colhoun said in a statement. “This could lead to improved management of comorbidities and, ultimately, enhance the quality of life for individuals with obesity.”

Several authors are employed by Novo Nordisk, the manufacturer of semaglutide.

What is semaglutide?

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a natural hormone produced in the gut that regulates blood sugar levels. Semaglutide mimics the effects of GLP-1, making it primarily used for treating type 2 diabetes. It’s available as both an injectable and a daily oral medication.

Semaglutide appears to be a promising tool for protecting and improving kidney health, particularly for those with diabetes or at high risk of kidney disease.

How does semaglutide benefit kidney health?

Recent research suggests semaglutide might offer unexpected benefits for kidney health. Here’s how:

  • Slowing Kidney Disease Progression: Studies like the FLOW trial (NCT03819153) showed a 24 percent reduction in the risk of major kidney events, including kidney failure and complications, in patients with type 2 diabetes and chronic kidney disease who received semaglutide compared to a placebo.

  • Protection in High-Risk Individuals: Research suggests semaglutide might even benefit those without diabetes. A study published in Nature highlighted potential protection against kidney disease in people with obesity and established heart disease.

How does semaglutide work to improve kidney health?

The exact mechanisms by which semaglutide improves kidney health are still under investigation. However, some theories suggest it might:

  • Reduce Blood Pressure: Semaglutide can help lower blood pressure, a significant risk factor for kidney disease.

  • Improve Blood Sugar Control: In diabetic patients, good blood sugar control is crucial for kidney health. Semaglutide’s effectiveness in regulating blood sugar could contribute to kidney protection.

  • Reduce Inflammation: Semaglutide might have anti-inflammatory properties that could benefit the kidneys by reducing inflammation-related damage.

Semaglutide warnings

While research is encouraging, it’s important to remember:

  • Semaglutide is not a cure for kidney disease.
  • More research is needed to fully understand the long-term effects of semaglutide on kidney health.
  • Semaglutide may have side effects. It’s crucial to discuss these with your doctor before starting the medication.

Read More About Diabetes & Endocrinology