Semaglutide markedly improves albuminuria and other important renal and metabolic parameters in patients with diabetic kidney disease (DKD) at high risk for progression, according to real-world data presented at the 58th European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Congress.

Investigators studied 122 patients with an estimated glomerular filtration rate (eGFR) higher than 15 but less than 60 mL/min/1.73 m2 or urinary albumin to creatinine ratio (UACR) exceeding 30 mg/g treated with semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. Over 12 months, semaglutide significantly decreased mean UACR by 53%, from 349.5 to 187.3 mg/g, Beatriz Avilés, MD, PhD, of Hospital Costa del Sol in Málaga, Spain, and colleagues reported. Mean eGFR remained relatively stable with a slight increase of 2.2 mL/min/1.73 m2.

Mean hemoglobin A1c (HbA1c) significantly decreased from 7.6% to 6.8%, which is within target range. Mild hypoglycemia occurred in only 5% of patients taking insulin, and rapid insulin requirement declined by 25%. Mean weight also significantly declined from 98.5 to 91.5 kg, representing a more than 5% weight loss for 69% of patients.

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Systolic blood pressure significantly declined from 129.95 to 120.09 mm Hg and diastolic blood pressure from 77.05 to 71.12 mm Hg. LDL cholesterol and triglyceridemia significantly decreased by 10.79 mg/dL and 29.15 mg/dL, respectively.

Semaglutide was discontinued in 5% of patients, commonly due to gastrointestinal intolerance.

“Our real-world study shows a significant reduction in albuminuria and weight with semaglutide treatment in patients with type 2 diabetes at high risk for kidney disease progression,” Dr Avilé told Renal & Urology News. “Hyperglycemia improved with only 5% of patients experiencing mild hypoglycemia with lower need of insulin. Semaglutide is safe and well tolerated and can ameliorate renal prognosis.”


Aviles B, García de Lucas MD, Perez Belmonte L, Jiménez Millán A, Rivas Ruiz F. Semaglutide in real-life practice decreases albuminuria in high-risk progression chronic kidney diabetic patients. Presented at the 58th ERA-EDTA Congress 2021, June 5-8, 2021. Abstract MO634.