The diabetes drug semaglutide, also known as Ozempic, has a positive effect on patients with chronic kidney disease and obesity. They have less protein in their urine, less inflammation in the kidneys and lower blood pressure.
This was shown by an international study led by clinical pharmacologist Hiddo L. Heerspink of the University Medical Center Groningen in the Netherlands. It is the first time that this diabetes drug, now known as a weight loss agent, has also been shown to be effective for patients with chronic kidney disease. The results of this study have been published in Nature Medicine and was presented concurrently at the annual meeting of the American Society of Nephrology.
Does a diabetes drug also work in chronic kidney disease without diabetes?
Hiddo L. Heerspink got the idea for this study at the beginning of the coronavirus pandemic. Earlier, he had discovered that another class of diabetes-2 drugs, the so-called SGLT2 inhibitors, also seemed to work well in patients with chronic kidney disease without diabetes. Therefore, he wanted to investigate whether semaglutide would also work positively in patients with chronic kidney disease and obesity.
Patients eagerly participated in the study
The first participants started this study in the second half of 2022. At that time, semaglutide was increasingly known to cause weight loss. As a result, getting participants excited about this study was not a problem at all. Many patients wanted the drug but could no longer obtain it because production could not keep up with demand. However, this study gave them a 50% chance of taking the drug.
The amount of protein in the urine was halved
The study was conducted in four countries: Canada, Germany, Spain and the Netherlands. Half of the 101 participants received 24 weeks of semaglutide injections, while the other half received a placebo. The study found that the amount of protein in the urine, an outcome measure that shows the degree of kidney damage, was reduced by up to 52%. In addition, the degree of kidney inflammation was found to decrease by 30%, the drop in participants’ blood pressure was as great as a blood pressure-lowering drug, and in them, a key measure of heart failure was reduced by 33%. Participants also lost about 10% of their weight.
The drug has a direct and indirect effect
Heerspink is very enthusiastic about these results. “The important thing is that the drug has both direct and indirect effects on the kidneys. The drug has direct effects on the parameters of inflammation in the kidneys and reduces the fatty tissue around the kidneys, reducing the amount of protein in the urine. And indirectly because it reduces the weight and blood pressure of the participants.’
Feeling hungry less often
The study was too short to measure improvement in participants’ quality of life or medium-term effects. “We sent the participants questionnaires about their diet. They seemed to be hungry less often and therefore eat less.’
Investigation of effect on hemodialysis and kidney transplants
Regarding the follow-up, Hiddo L Heerspink is clear: “All messages are green to test this drug in a large study. I would like to know if it can lead to fewer dialysis or kidney transplants. And I would also very much like to investigate whether this drug also works positively in patients with kidney damage without obesity. It is very difficult now to get enough of the drug to do the studies due to its unprecedented popularity.
Source:
Journal Reference:
Apperloo, EM, et al. (2024). Semaglutide in overweight or obese patients with chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial. Nature Medicine. doi.org/10.1038/s41591-024-03327-6.
