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Chronic kidney failure

Semaglutide Reduces Risk of Major Kidney Outcomes in Type 2 Diabetes Patients

Strategic Insights

— 2 min read

New research conducted by investigators at the University of Chicago Medicine has found that semaglutide, a medication used to treat type 2 diabetes, significantly reduces the risk of major kidney outcomes and all-cause mortality in patients with chronic kidney disease. The study, which was supported by Novo Nordisk A/S, analyzed data from the Evaluate Renal Function With Semaglutide Once Weekly (FLOW) trial and found that semaglutide was effective in reducing the risk of major kidney outcomes, major adverse cardiovascular events, and all-cause mortality in patients with type 2 diabetes and chronic kidney disease, regardless of baseline mineralocorticoid receptor antagonist use.

Key Takeaways:

  • The Evaluate Renal Function With Semaglutide Once Weekly (FLOW) trial found that semaglutide reduced the risk of major kidney outcomes by 49% in mineralocorticoid receptor antagonist (MRA) users and 21% in non-users.
  • Semaglutide reduced the risk of major adverse cardiovascular events (MACE) and all-cause mortality in both MRA subgroups, with a P-interaction of 0.7.
  • The safety profile of semaglutide was comparable between subgroups, with no significant differences in adverse events.
  • The study concluded that semaglutide provides consistent benefits on major kidney outcomes, MACE, and all-cause mortality in patients with type 2 diabetes and chronic kidney disease, regardless of baseline MRA use.
  • The research was conducted by a team of investigators from the University of Chicago Medicine, led by George Bakris, and included additional authors from institutions such as Novo Nordisk A/S and the University of California, San Francisco.

Statistics:

  • Semaglutide reduced the risk of the primary kidney outcome by 49% in MRA users (59 events; hazard ratio [HR] 0.51 [95% CI 0.30, 0.86]).
  • Semaglutide reduced the risk of major kidney outcomes by 21% in non-MRA users (682 events; HR 0.79 [95% CI 0.68, 0.92]; P-interaction = 0.12).
  • Semaglutide reduced albuminuria at 104 weeks by 15% in MRA users (95% CI -41, 31) and 33% in non-users versus placebo (P-interaction = 0.22).
  • Estimated glomerular filtration rate decline was similarly reduced with semaglutide in both MRA subgroups (P-interaction = 0.71).

Sources:

  • "Effects of Semaglutide With or Without Concomitant Mineralocorticoid Receptor Antagonist Use in Participants With Type 2 Diabetes and Chronic Kidney Disease: A FLOW Trial Prespecified Secondary Analysis." Diabetes Care, 2025;48(11):1878-1887.
  • NewsRx. New Findings on Type 2 Diabetes from University of Chicago Medicine Summarized (Effects of Semaglutide With or Without Concomitant Mineralocorticoid Receptor Antagonist Use in Participants With Type 2 Diabetes and Chronic Kidney Disease: A FLOW ...). Diabetes Week. November 3, 2025; p 253.

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