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Brand names: Ozempic / Wegovy • Drug class: GLP-1 receptor agonist
Semaglutide is a GLP-1 receptor agonist used for type 2 diabetes and obesity. The FLOW trial (NEJM 2024) showed it significantly slows kidney disease progression in people with type 2 diabetes and CKD — one of the most important kidney-protective findings of the decade.
Beyond weight loss and glucose control, semaglutide reduces albuminuria, slows eGFR decline, and lowers the risk of kidney failure by about 24% in diabetic CKD. It can be started regardless of eGFR (in diabetes), continues to benefit even at low GFR, and is stopped only at dialysis.
24% lower risk of kidney disease progression or kidney/cardiovascular death in CKD with type 2 diabetes
FLOW trial (Perkovic V et al., NEJM 2024), 2024
~33% reduction in albuminuria progression in the FLOW population
FLOW trial secondary analysis, 2024
Eligibility at any eGFR; benefit independent of baseline GFR
FLOW trial subgroup analysis, 2024
No dose adjustment for kidney function. Semaglutide can be used at any eGFR including advanced CKD (not on dialysis). Gastrointestinal side effects (nausea) are the main tolerability issue.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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This content is a general reference, not medical advice, a diagnosis, or a treatment plan. Do not change your diet, fluids, medicines, or dialysis plan without your nephrologist or renal dietitian. Individual recommendations depend on your labs, medications, conditions, and care plan.