Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial

Oct 25, 2024Nature medicine

Semaglutide effects in overweight or obese patients with chronic kidney disease but no diabetes: a randomized placebo-controlled trial

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Abstract

Semaglutide reduced urine albumin-to-creatinine ratio by 52.1% after 24 weeks in patients with type 2 diabetes and chronic kidney disease.

The study involved 101 participants with chronic kidney disease, randomized to receive either semaglutide or placebo.
Mean age of participants was 55.8 years, with a median urine albumin-to-creatinine ratio of 251 mg/g.
Semaglutide treatment was associated with a significant decrease in albuminuria compared to placebo.
Gastrointestinal side effects were reported more frequently in participants receiving semaglutide than those on placebo.
This treatment may provide a clinically meaningful improvement in kidney health for patients with overweight/obesity and non-diabetic chronic kidney disease.

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Semaglutide reduces albuminuria and the risk of kidney disease progression in patients with type 2 diabetes and chronic kidney disease (CKD). We conducted a randomized placebo-controlled double-blind clinical trial in adults with CKD (estimated glomerular filtration rate (eGFR) ≥25 ml min 1.73 mand urine albumin-to-creatinine ratio (UACR) ≥30 and <3,500 mg g) and body mass index ≥27 kg m. Participants were randomized to semaglutide 2.4 mg per week or placebo. The primary endpoint was percentage change from baseline in UACR at week 24. Safety was monitored throughout. Overall, 125 participants were screened, of whom 101 were randomized to semaglutide (n = 51) or placebo (n = 50). Mean age was 55.8 (s.d. 12) years; 40 participants (39.6%) were female; median UACR was 251 mg g(interquartile range 100, 584); mean eGFR was 65.0 (s.d. 25) ml min 1.73 m; and mean body mass index was 36.2 (s.d. 5.6) kg m. Chronic glomerulonephritis (n = 25) and hypertensive CKD (n = 27) were the most common CKD etiologies. Treatment for 24 weeks with semaglutide compared to placebo reduced UACR by -52.1% (95% confidence interval -65.5, -33.4; P < 0.0001). Gastrointestinal adverse events were more often reported with semaglutide (n = 30) than with placebo (n = 15). Semaglutide treatment for 24 weeks resulted in a clinically meaningful reduction in albuminuria in patients with overweight/obesity and non-diabetic CKD. ClinicalTrials.gov registration: NCT04889183 . -1 -2 -1 -2 -1 -1 -2 -2

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Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial

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