The diabetes medication semaglutide has been shown to significantly reduce the risk of kidney failure and death in individuals with type 2 diabetes and chronic kidney disease.
The clinical trial, conducted by University or New South Wales’ researchers and published in the New England Journal of Medicine, found that the medication can reduce the risk of kidney failure, slow the significant loss of kidney function, and lower the risk of death from kidney or cardiovascular causes.
Researchers are optimistic that semaglutide, which is already used for managing diabetes and obesity, could eventually benefit a broader population with kidney disease.
More on the trial
The trial, which included over 3,500 participants with type 2 diabetes and chronic kidney disease from 28 countries – such as Australia, the USA, and China – revealed that a small weekly dose of semaglutide reduced the risk of major kidney events by 24%. Additionally, the risk of cardiovascular events, including heart attacks and strokes, was 18% lower for those receiving semaglutide. The trial, which was placebo-controlled and administered semaglutide to half of the participants, also showed a 20% reduction in the risk of death from any cause.
Semaglutide’s benefits are significant given the strong link between kidney disease and heart disease, explains Samir Parikh, a nephrologist at the University of Texas Southwestern Medical Center, in Scientific American’s article. People with type 2 diabetes and chronic kidney disease often succumb to heart disease before their kidney issues worsen. Dr. Parikh noted that the interplay between heart and kidney disease, exacerbated by diabetes, is particularly damaging.
The study’s lead author Professor Vlado Perkovic described the benefits revealed in the trial as ‘greater than expected’, but acknowledged the chronic, worldwide shortage of semaglutide medications.
‘We would be saving kidneys, hearts and lives in this population by making this drug available to them and that’s quite extraordinary for one treatment to be able to do,’ he said.
‘We’re really starting to dramatically improve outcomes for people with diabetes and kidney disease. But that will only happen if the results are translated into action at the clinical coalface, so that’s an important next step.
‘The challenge is to get these results into clinical practice, to get the drug used by the people who will benefit from it, who will live longer without dialysis, without heart attacks, without strokes, if they take this drug.’
Why does this research matter so much?
Dr. Katherine Tuttle, nephrologist at the University of Washington and co-leader of the study, expressed enthusiasm about the positive impact of semaglutide on chronic kidney disease (CKD) patients. Historically, these patients haven’t experienced the same reduction in heart-related deaths as the general population, highlighting the necessity for new treatments.
Traditional CKD management has relied on blood pressure medications, which provide limited kidney protection. Recent advancements, like SGLT2 inhibitors, offer additional benefits by slowing disease progression and protecting against cardiovascular events. However, Dr. Tuttle emphasised the need for more therapies to address the significant residual risk in diabetic kidney disease, the leading cause of CKD globally.
Previous research hinted at semaglutide’s kidney-protective effects, but mainly in the context of heart disease. This latest study, however, specifically examined its role in slowing kidney disease progression. Participants treated with semaglutide showed improved kidney function and lower urinary albumin levels. While the exact mechanisms are unclear, researchers speculate that semaglutide may reduce kidney inflammation, with further studies needed to compare it to other treatments and explore its benefits for non-diabetic CKD patients.
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