Semaglutide in type 2 diabetes with chronic kidney disease at high risk progression-real-world clinical practice
Aviles Bueno, Beatriz (Hospital Costa del Sol (Marbella))
Soler, María José (Hospital Universitari Vall d'Hebron)
Perez-Belmonte, Luis (Hospital Regional Universitario de Málaga)
Jimenez Millan, Anabel (Hospital Universitario Puerto Real (Cadis))
Rivas Ruiz, Francisco (Hospital Costa del Sol (Marbella))
Garcia De Lucas, Maria Dolores (Research Unit (Marbella))
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Albuminuria ; Diabetic chronic disease ; GLP-1RA ; Obesity ; Semaglutide
Publicat a:	Clinical Kidney Journal, Vol. 15 Núm. 8 (january 2022) , p. 1593-1600, ISSN 2048-8513

DOI: 10.1093/ckj/sfac096
PMID: 35892023

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