Abstract

ABSTRACT

Background

Semaglutide [glucagon-like peptide-1 receptor-agonist (GLP-1RA)] has shown nephroprotective effects in previous cardiovascular studies. However, its efficacy and safety in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) have been rarely studied.

Methods

This is a multicenter, retrospective, observational study in patients with T2D and CKD with glycosylated hemoglobin A1c (HbA1c) of 7.5–9.5% treated with subcutaneous semaglutide for 12 months in real-world clinical practice. The main objectives were glycemic control as HbA1c <7% and weight loss >5%.

Results

We studied a total of 122 patients, ages 65.50 ± 11 years, 62% men, duration of T2D 12 years, baseline HbA1c 7.57% ± 1.36% and an estimated glomerular filtration rate (eGFR) 50.32 ± 19.21 mL/min/1.73 m2; 54% had a urinary albumin:creatinine ratio (UACR) of 30–300 mg/g and 20% had a UACR >300 mg/g. After 12 months of follow-up, HbA1c declined −0.73% ± 1.09% (P < .001), with 57% of patients achieving values <7% and weight loss of −6.95 kg (P < .001), with 59% of patients showing a reduction of >5% of their body weight. Systolic and diastolic blood pressure decreased −9.85 mmHg and −5.92 mmHg, respectively (P < .001). The mean UACR decreased 51% in the group with baseline macroalbuminuria (UACR >300 mg/g). The mean eGFR (by the Chronic Kidney Disease Epidemiology Collaboration) remained stable. The need for basal insulin decreased 20% (P < .005). Only 7% of patients on insulin had mild hypoglycemic episodes. Semaglutide was stopped in 5.7% of patients for digestive intolerance.

Conclusions

In this real-world study, patients with T2D and CKD treated with subcutaneous semaglutide for 12 months significantly improved glycemic control and decreased weight. Albuminuria decreased by >50% in patients with macroalbuminuria. The administration of GLP-1RA in patients with T2D and CKD was safe and well tolerated.

Details

Title
Semaglutide in type 2 diabetes with chronic kidney disease at high risk progression—real-world clinical practice
Author
Beatriz Aviles Bueno 1   VIAFID ORCID Logo  ; Soler, Maria Jose 2   VIAFID ORCID Logo  ; Perez-Belmonte, Luis 3 ; Anabel Jimenez Millan 4 ; Francisco Rivas Ruiz 5 ; Maria Dolores Garcia de Lucas 6 

1  Costa del Sol Hospital, Nephrology Department, Málaga , Spain 
2  Vall D´Hebron University Hospital, Nephrology Department, Universitat Autònoma de Barcelona , Barcelona , Spain 
3  Regional University Hospital and Biomedical Research Institute, Internal Medicine Department Málaga , Spain 
4  Puerto Real University Hospital, Endocrinology Department , Cádiz , Spain 
5  Costa del Sol Hospital, Internal Medicine Department, Málaga , Spain 
6  Research Unit , Marbella , Málaga, Spain 
Pages
1593-1600
Publication year
2022
Publication date
Aug 2022
Publisher
Oxford University Press
ISSN
20488505
e-ISSN
20488513
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/ckj/sfac096
ProQuest document ID
3169602492
Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.