Semaglutide has a positive effect on patients with chronic kidney disease and obesity. By decreasing the amount of protein in urine, the degree of inflammation of their kidneys and their blood pressure, according to an international study led by clinical pharmacologist, Dr Hiddo L Heerspink of the University Medical Center Groningen in The Netherlands.
“The great thing is that the drug has both direct and indirect effects on the kidneys. The drug has direct effects on inflammation parameters in the kidney, and lowers fat tissue around the kidneys, lowering the amount of protein in the urine,” said Heerspink. “And indirectly, because it reduces participants' weight and blood pressure."
Heerspink and colleagues previously reported that another class of drugs against type 2 diabetes, SGLT2 inhibitors, also appeared to work well for patients with chronic kidney damage without diabetes. He therefore wanted to investigate whether semaglutide would also work positively for patients with chronic kidney disease and obesity.
The first participants started this study in the second half of 2022. At that time, it had become increasingly known that semaglutide caused weight loss. As a result, getting participants excited about this study was no problem at all, as patients wanted the drug but could no longer get it because production could not keep up with demand. This study gave them a 50% chance of getting the drug though.
The study was conducted in four countries: Canada, Germany, Spain and the Netherlands. Half of the 101 participants received 24-week injections of semaglutide, while the other half received a placebo. The study found that the amount of protein in urine, an outcome measure indicating the degree of kidney damage, was reduced by as much as 52%.
Furthermore, the degree of kidney inflammation was found to decrease by 30%, the participants' blood pressure drop was as large as a blood pressure-lowering drug gives, and in them, a key measure of heart failure was reduced by 33%. Participants also lost about 10% of their weight.
"All signals are green to test this drug in a large study. I would like to find out whether it can lead to fewer dialyses or kidney transplants. And I would also very much like to investigate whether this drug also works positively in patients with kidney damage without obesity,” he added. “It is only very difficult now to get enough of the drug to do the studies due to its unprecedented popularity."
The findings were featured in the paper, ‘Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial’, published in Nature Medicine. To access this paper, please click here (log-in maybe required)
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