Semaglutide May Prevent Kidney Disease in Obesity

The Mask of the Red DeathThis moment has been a long time coming. Solid evidence that people live longer, healthier lives when they receive effective treatment for obesity is adding up. On Friday, we learned that semaglutide cuts kidney failure and death in diabetes. Then, over the weekend, Nature Medicine published a study showing that semaglutide may prevent kidney disease in people with obesity and heart disease, but no diabetes.

Lead author and public health professor Helen Colhoun explains the significance of this new publication:

“These data are important because they are the first data to suggest a kidney benefit of semaglutide in this patient population in the absence of diabetes. This is a population at high risk of chronic kidney disease with an increased need for kidney protection.”

Evidence from SELECT

This finding comes from a prespecified analysis of the SELECT RCT in persons with cardiovascular disease and obesity or overweight. It was that study which led FDA to approve a new indication of Wegovy (semaglutide) for preventing deaths, strokes, and heart attacks in persons in this population.

The point of this analysis was to look for evidence that semaglutide prevents kidney disease and its progression in obesity. The primary outcome was a composite of death due to kidney disease, impaired kidney function, initiation of dialysis, or a kidney transplant. Remembering that these were patients at risk for cardiovascular death, perhaps it’s unsurprising that deaths due to kidney disease were not a factor in the results. None were seen in either group.

What was a factor, apparently, was the prevention of kidney disease. Nephrologist Alberto Ortiz told Medscape:

“It is especially significant that protection was observed in participants with an eGFR >60 mL/min/1.73 m2 and across UACR categories, including people without chronic kidney disease (CKD) at baseline, in whom it appeared to decrease the incidence of de novo CKD. This suggests a potential role in primary prevention of CKD in this population.”

Diabetes and hypertension are two complications of obesity that put people at risk for chronic kidney disease. So it is good news indeed that semaglutide for obesity may serve to prevent kidney disease.

Click here for this new study in Nature Medicine, here and here for further perspective on it.

The Mask of the Red Death, artwork in charcoal by Odilon Redon / WikiArt

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May 28, 2024