Diabetes drug Semaglutide may reduce kidney damage, study finds

Semaglutide, the diabetes drug also known as Ozempic, has shown positive effects in treating patients with chronic kidney disease (CKD) and obesity, as revealed in an international study led by clinical pharmacologist Hiddo L. Heerspink from the University Medical Center Groningen in the Netherlands.

This groundbreaking study is the first to demonstrate that semaglutide, often recognised for its weight-loss benefits, can also improve kidney health in patients suffering from CKD. The findings have been published in Nature Medicine and presented at the American Society of Nephrology's annual congress.

Study Background and Motivation

Heerspink was inspired to investigate semaglutide’s effects on CKD patients at the onset of the COVID-19 pandemic, following his earlier findings that SGLT2 inhibitors—another class of drugs used to treat type 2 diabetes—had shown benefits for CKD patients without diabetes. This prompted him to explore whether semaglutide could offer similar advantages for patients with kidney damage and obesity, marking a significant new area of research.

Patient Recruitment and Study Design

Recruiting participants was seamless, as interest surged around 2022, driven by semaglutide’s well-known weight-loss benefits. Patients who struggled to access the drug due to high demand eagerly joined the study, where they had a 50% chance of receiving semaglutide. This trial was conducted in four countries—Canada, Germany, Spain, and the Netherlands—with a total of 101 participants, divided into two groups. Half received 24-week injections of semaglutide, while the others received a placebo.

Significant Findings

The study’s outcomes were notable. The amount of protein in participants' urine—a critical marker of kidney damage—dropped by an impressive 52%.

Additionally, kidney inflammation decreased by 30%, and blood pressure reduction was comparable to that seen with blood pressure medications. A key marker for heart failure risk also fell by 33%. Alongside these benefits, participants experienced an average weight loss of 10%.

Direct and Indirect Benefits for Kidney Health

Heerspink highlighted the drug’s multi-faceted impact, which involves both direct and indirect benefits for kidney health. Semaglutide directly reduced inflammatory markers within the kidneys and lowered fat deposits around them, which contributed to decreased protein levels in the urine. Indirectly, the drug helped reduce both the patients’ weight and blood pressure, amplifying the overall benefits for kidney function.

Observed Dietary Changes

While the study duration was too short to track longer-term quality of life improvements, Heerspink noted that questionnaires revealed reduced hunger among participants, which led them to consume less food overall.

Future Prospects: Large-Scale Study on Dialysis and Transplants

Heerspink is optimistic about the potential of semaglutide for CKD treatment and has suggested conducting a larger study to determine if it can reduce the need for dialysis or kidney transplants. He also hopes to explore its effects on CKD patients without obesity.

However, Heerspink acknowledged the current challenge of securing enough of the drug for further research due to its overwhelming popularity and limited production.

This study presents a promising new treatment avenue for CKD patients, with semaglutide showing potential to address both kidney health and obesity, offering an expanded role beyond diabetes management.