Semaglutide use tied to lower kidney disease risk in obesity

By Staff 9 Min Read

  • Both obesity and cardiovascular disease can increase a person’s risk of developing kidney disease.
  • A recent study found that semaglutide may help reduce the progression of kidney disease in people with type 2 diabetes.
  • A new study from researchers at the University of Edinburgh, in the United Kingdom, says semaglutide may also help protect kidney function in people who are overweight or obese with established cardiovascular disease.

Previous research shows that both obesity and cardiovascular disease can raise a person’s risk of developing kidney disease.

A recently published study found that semaglutide— the active ingredient in glucagon-like peptide-1 (GLP-1) receptor agonist medications Ozempic and Wegovy — may help reduce the progression of kidney disease in people with type 2 diabetes.

Now, research recently presented at the 61st European Renal Association Conference in Stockholm, Sweden, reports semaglutide may also help protect kidney function in people who have overweight or obesity and also have established cardiovascular disease.

The research has not yet been published in a peer-reviewed journal.

This study’s results are from the SELECT (Semaglutide Effects on Heart Disease and Stroke in Patients with Overweight or Obesity) trial, which includes more than 17,000 participants.

After an average follow-up of about 3.5 years, scientists discovered that adverse kidney-related events — such as a significant decline in kidney function, death from kidney causes, or onset of persistent macroalbuminuria — were experienced by 22% fewer participants in the group receiving semaglutide injections compared to the placebo group.

“By addressing key markers of kidney health, semaglutide 2.4 mg [milligrams] weekly may contribute to a significant reduction in the risk of kidney-related complications, including chronic kidney disease and end-stage renal disease,” said Prof. Helen M. Colhoun, MD, the AXA Chair in Medical Informatics and Life Course Epidemiology at the University of Edinburgh in Scotland, United Kingdom, and lead author of this study, in a press release.

“This could lead to improved management of comorbidities and, ultimately, enhance the quality of life for individuals with obesity,” she suggested.

Researchers examined how semaglutide might impact a person’s estimated glomerular filtration rate (eGFR), which measures how much waste and excess water the kidneys filter out of the blood through urine.

Participants receiving semaglutide had a significantly lower decline in eGFR than those in the placebo group, indicating semaglutide’s potential kidney function protection in people with pre-existing kidney impairment.

The scientists also looked at how semaglutide affected participants’ urinary albumin-to-creatinine ratio (UACR). UACR measures the ratio of the protein albumin to waste product creatinine in the urine, which helps doctors determine if a person has albuminuria, which can be a sign of kidney issues.

In participants using semaglutide, compared to baseline measurements researchers reported an average 8.1% decrease in UACR with those with normal albumin levels, a 27.2% decrease in those with microalbuminuria, and a 31.4% decrease in those with macroalbuminuria compared to those receiving the placebo.

“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,” Colhoun said in the press release.

“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,” she added.

Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA — who was not involved in this study — told Medical News Today this study’s findings were not surprising.

“We’ve found with any kind of weight loss — whether it’s from the medications, surgical, or just even diet and exercise — all organ functions seem to improve in people who are significantly overweight. So the fact that kidney function is protected and improved with weight loss is good that it be documented, but it’s not surprising to me.”

– Mir Ali, MD

Ali explained that when somebody is significantly overweight or obese, they’re stressing all their organs including the kidneys, heart, lungs, and liver.

“All their organs are working less efficiently, having to work harder, because they have to process more things through the body,” he continued.

“So when you lose weight, it takes that extra stress off the organ. There’s also a significant component of inflammation that occurs with obesity, and that inflammation can affect the kidneys, heart, [and] lungs,” Ali detailed.

MNT also spoke with Cheng-Han Chen, MD, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA — who was also not involved in this study — about why cardiovascular disease could negatively impact kidney function.

“A lot of kidney function itself depends on the heart function as the kidneys’ job is to filter blood, and its efficacy depends on how well the blood is sent to the kidney from the cells,” Chen explained.

“In addition, many of the disease processes in cardiovascular disease, such as atherosclerosis, can also affect the blood vessels in the kidney,” he pointed out.

“Furthermore, the kidneys function themselves conversely from heart function, as some of the function of the kidneys is to regulate blood vessel dilation and constriction,” Chen added. “And so this hypotension also affects the health of blood vessels of the heart.”

Chen said it is important for researchers to continue to find new ways of protecting kidney function in people who are obese with heart disease because kidney disease has significant morbidity and mortality in the United States.

“So any treatments we have to slow the progression of kidney disease have the potential to benefit a large portion of the American population,” he continued.

“It is encouraging to see that semaglutide — an important medication that has been shown to be beneficial in patients with diabetes, as well as patients with obesity — has the capability of slowing [the] progression of kidney disease as well,” commented Chen.

“Future longer-term research [should] look to see if this benefit to kidney function will extend out to prevent poor kidney outcomes such as initiation of dialysis or even kidney transplant,” he advised.

Ali said that through future research, it would be interesting to see if this improvement in kidney function through the use of semaglutide is independent of weight loss.

“There was a recent study looking at cardiovascular health and they found that semaglutide improves cardiovascular health, independent of weight loss,” he told us. “So even if patients didn’t lose a lot of weight, their cardiovascular health improved with [the] use of semaglutide.”

“The theory is it has a reduction in inflammation, so it would be interesting to see if that’s also true for the kidneys — is that improvement in kidney function or protection of the kidneys independent of the weight loss or is it directly related to the weight loss?” Ali added.

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