Semaglutide, a GLP-1 receptor agonist, has demonstrated a significant reduction in albuminuria in adults with chronic kidney disease (CKD) who are overweight or obese but do not have diabetes, according to study data presented at ASN Kidney Week. The trial, led by Hiddo Jan L. Heerspink, PhD, from the University Medical Center Groningen, suggests a potential new therapeutic avenue for managing CKD in non-diabetic patients.
The study involved 101 participants with an eGFR of at least 25 mL/min/1.73 m2, a UACR between 30 mg/g and 3,500 mg/g, and a BMI of 27 kg/m2 or greater. Participants were randomized to receive either semaglutide or a placebo for 12 weeks, followed by a 16-week washout period. Notably, none of the participants had diabetes or a history of cardiovascular disease within three months prior to the study. A subset of participants were prescribed an SGLT2 inhibitor (8 in the semaglutide group and 11 in the placebo group).
Significant Reduction in Albuminuria
The results showed that semaglutide was associated with a 52.1% (95% CI, 33.4-65.5) greater reduction in UACR compared to the placebo. According to Dr. Heerspink, the reduction in UACR occurred as semaglutide was titrated up every four weeks, with the levels remaining lower than baseline even at the end of the washout period. No significant difference in eGFR was observed between the two groups.
Additional Benefits Observed
In addition to the primary outcome, participants in the semaglutide group experienced significant reductions in blood pressure, body weight, waist circumference, and high-sensitivity C-reactive protein compared to the placebo group. These findings suggest a broader range of benefits beyond kidney-specific markers.
Safety Profile and Future Directions
Adverse events were more common in the semaglutide group, primarily involving gastrointestinal issues, which aligns with the known safety profile of the drug. Dr. Heerspink emphasized the need for longer and larger clinical trials to fully assess semaglutide's potential, including its effects on clinical kidney outcomes and its applicability to patients with lower BMI.
