Semaglutide May Protect Kidneys of People With CV Disease and Overweight, Obesity

The Semaglutide Effects on Heart Disease and Stroke in Patients with Overweight or Obesity (SELECT) trial found that the glucagon-like peptide 1 receptor agonist semaglutide helped stem a decline in kidney function among nondiabetic patients with overweight and obesity plus cardiovascular (CV) disease. Helen M. Colhoun and fellow researchers presented the SELECT findings at the 61st European Renal Association Congress.

There were 17,604 individuals in the randomized trial, with an average follow-up period of 3.5 years. Adverse kidney-related events occurred among 22% fewer patients in the group that received a once-weekly subcutaneous injection of semaglutide 2.4 mg (1.8%, n=8803) versus a placebo group (2.2%, n=8801; P<.05). Adverse kidney-related events included death from kidney causes, initiation of chronic kidney replacement therapy, ≥50% decline in kidney function, or onset of persistent macroalbuminuria.

Semaglutide was also associated with a lesser decline in estimated glomerular filtration rate (eGFR) and a reduction in urinary albumin-to-creatinine ratio (UACR). Compared with the placebo group, the semaglutide group saw a net 8.1% decrease in UACR for patients with normal albumin levels at baseline, 27.2% for those with albuminuria category A2 (microalbuminuria) at baseline and 31.4% for those with albuminuria category A3 (macroalbuminuria) at baseline. Also, there was no increased risk of acute kidney injury associated with semaglutide treatment, regardless of baseline kidney function.

Colhoun noted, “The observed benefits in eGFR and UACR are particularly encouraging, suggesting potential for the enhanced management of kidney complications in the patient population with overweight and obesity without diabetes. The findings also underscore the importance of continued research into the possible renal benefits of semaglutide and highlight its role as a promising therapeutic option in the multifaceted management of cardiovascular and renal health in this high-risk population.”

 Source: Colhoun HM, Lingvay I, Brown PM, et al. Effect of semaglutide on kidney outcomes in people with overweight or obesity and established cardiovascular disease in the SELECT trial. Abstract #2496. Presented at the 61st European Renal Association Congress; May 23-26, 2024; Stockholm, Sweden.