This content originally appeared on Everyday Health. Republished with permission.
By Don Rauf
Key Takeaways
Semaglutide significantly lowered the rate of complications in individuals with diabetes and chronic kidney disease.
People on semaglutide saw an 18 percent drop in their risk of cardiovascular complications like heart attack and a 20 percent drop in the risk of death from any cause.
Common side effects of semaglutide include nausea, vomiting, and diarrhea.
Often called a wonder drug for type 2 diabetes and obesity, semaglutide — the active ingredient in Ozempic and Wegovy — may significantly improve kidney function in people with diabetes who have chronic kidney disease.
New research results presented this week at the Annual Scientific Sessions of the American Diabetes Association (ADA) showed that semaglutide reduced the likelihood of major kidney disease–related events — specifically kidney failure, substantial loss of kidney function, and death from kidney or cardiovascular causes — in these patients by 24 percent.
The study, which was published in the journal Nature Medicine, also found that semaglutide may provide additional benefit for individuals who are already taking diabetes medications called SGLT2 inhibitors, such as Jardiance (empagliflozin), Farxiga (dapagliflozin), and Invokana (canagliflozin).[1]
“This is a patient population at high risk of severe kidney outcomes,” said Richard E. Pratley, MD, a study author and medical director at the AdventHealth Diabetes Institute Orlando, Florida, in a statement. “Despite existing treatment options, there is still a clear unmet need for this group. The findings from the trial have the potential to change the disease course of these high-risk patients and pave the way for new treatment strategies, offering hope to millions of patients globally.”
Diabetes is the leading cause of chronic kidney disease (CKD), and about 30 to 40 percent of type 2 patients are estimated to have the condition.[2]
Risk of Death From Heart Attacks and Other Causes Dropped by 20 Percent
When kidneys don’t work well, there is more pressure on the heart, which in part explains why people living with type 2 diabetes are more likely than others to develop and die from cardiovascular diseases, such as heart attacks, strokes and heart failure.[3]
In this trial, which followed more than 3,500 people with type 2 diabetes and chronic kidney disease over an average of 3.4 years, people who took a weekly shot of semaglutide in addition to standard care experienced 18 percent fewer major cardiovascular events than those receiving a placebo. The risk of death from any cause was 20 percent lower in the semaglutide group.
Semaglutide Also Helped People Already Taking Other Drugs That Boost Kidney Health
Because SGLT2 inhibitors for diabetes treatment are also effective at slowing the progression of kidney disease, the researchers wanted to see if semaglutide would have additional benefit for patients taking these drugs.[4]
In an analysis of 550 participants who were taking either SGLT2 inhibitors or a placebo, scientists found that semaglutide’s benefit was comparable with or without SGLT2 use.
“We can say that semaglutide reduced the risk of the major kidney outcomes in people with type 2 diabetes, irrespective of baseline SGLT2 inhibitor used,” said Katherine Tuttle, MD, a study author in the division of nephrology at the University of Washington in Seattle, during the ADA meeting presentation.
How Semaglutide May Help Kidney Disease
Study authors noted that semaglutide takers had an improved estimated glomerular filtration rate (a test that measures your level of kidney function) compared with the placebo group.
They also lost about nine pounds on average.
“Semaglutide works by mimicking a natural hormone, GLP-1, to slow stomach emptying, and by acting on hunger centers in the brain that lead to individuals feeling more full when eating, and therefore eating less and losing weight,” explains Robert Gabbay, MD, the chief scientific and medical officer for the American Diabetes Association.
But, he adds, “The mechanism of the drug’s effect on kidney disease is not entirely clear.”
Because extra weight pushes the kidneys to work harder and filter wastes above the normal level, Ty Diwan, MD, a transplant surgeon with the Mayo Clinic in Rochester, Minnesota, suspects weight loss to be a driving factor in improving outcomes.
“The study results help to emphasize the role that obesity plays in renal [kidney] disease and exemplifies how treatment of obesity, via medications or surgery, can potentially improve chronic renal disease,” says Dr. Diwan, who was not involved in the research.
Semaglutide Comes With Side Effects
While calling these new findings “exciting,” Alyssa Dominguez, MD, an endocrinologist with Keck Medicine of USC in Los Angeles, offers a few words of caution about common side effects of semaglutide.
“Patients should be counseled about potential gastrointestinal adverse effects such as nausea, vomiting, and diarrhea,” says Dr. Dominguez, who was not involved in the study. People on these medications need to stay well-hydrated, she adds, and should contact their doctor if they experience serious side effects.
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Sources
Mann J et al. Effects of Semaglutide With and Without Concomitant SGLT2 Inhibitor Use in Participants With Type 2 Diabetes and Chronic Kidney Disease in the FLOW Trial. Nature Medicine. June 24, 2024.
Feng X et al. CKD Prevalence Among Patients With and Without Type 2 Diabetes: Regional Differences in the United States. Kidney Medicine. January 2022.
Cardiovascular Disease and Diabetes. American Heart Association. April 2, 2024.
Game-Changing Medications for Kidney Disease and Type 2 Diabetes. National Kidney Foundation. March 21, 2023.