Effects of Semaglutide on Kidney Parameters in Patients with Obesity and Nondiabetic CKD
Bibliographic record
Abstract
Background: Semaglutide is a glucagon like peptide 1 receptor agonist which reduces albuminuria and the risk of kidney failure in patients with type 2 diabetes and chronic kidney disease (CKD). We assessed the effects of semaglutide in patients with overweight/obesity and albuminuric CKD without diabetes. Methods: We conducted a multicenter randomized placebo-controlled clinical trial in adults with CKD (eGFR ≥25 mL/min/1.73m2, urine albumin-to-creatinine ratio [UACR] ≥30 and <3500 mg/g), body mass index ≥27 kg/m2 and HbA1c <6.5% without use of hypoglycemic agents. Participants were randomized to 24 weeks treatment with subcutaneous semaglutide 2.4 mg/week or placebo adjunctive to renin-angiotensin-system inhibition when indicated. The primary endpoint was percentage change from baseline in UACR at week 24. Secondary endpoints included change in iohexol measured GFR, estimated GFR, body weight, and systolic blood pressure (BP). Safety was monitored throughout. Results: Of 125 screened participants, 101 were randomized to semaglutide or placebo. Mean age was 55.8 (SD 12) years, 40 (39.6%) were female, median UACR was 251 mg/g (IQR 100, 584), eGFR 65.0 (SD 25) mL/min/1.73m2. Chronic glomerulonephritis (N=25) and hypertensive CKD (N=27) were the most common CKD etiologies. At week 24, the placebo-corrected geometric mean change from baseline in UACR with semaglutide was -52.1% (95%CI -65.2, -34.1; p<0.0001). Compared to placebo, mGFR was changed at week 24 with semaglutide by -1.9 mL/min/1.73m2 (95%CI -8.0, 4.3). Corresponding changes in eGFR-creatinine and eGFR-cystatin C were -1.1 (95%CI -4.8, 2.6) and +2.1 mL/min/1.73m2 (95%CI -1.7, 5.9), respectively. Semaglutide compared to placebo changed body weight by -9.1 kg (95%CI -11.1, -7.1) and systolic BP by -6.3 mmHg (95%CI -11.1, -1.5). Gastrointestinal adverse events were more often reported in the semaglutide (N=30) versus placebo group (N=15). Conclusion: Treatment with semaglutide for 24 weeks in patients with overweight/obesity and CKD without diabetes resulted in a robust and clinically meaningful reduction in UACR. These results support further trials to assess long-term efficacy and safety of semaglutide in these patients. Funding: Commercial Support - Novo Nordisk provided a grant to the University Medical Center Groningen to conduct this investigator initiated clinical trial
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".