Assessing the Renal Outcomes of Semaglutide in Diabetic Kidney Disease: A Systematic Review

Diabetic kidney disease (DKD) is a prevalent microvascular complication of diabetes, posing a significant health burden. Semaglutide, a glucagon-like peptide-1 receptor agonist, has shown promise in mitigating renal outcomes in DKD. This systematic review aimed to evaluate the renal effects of semag...

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Published in:Curēus (Palo Alto, CA) CA), 2024-07, Vol.16 (7), p.e64038
Main Authors: Rehman, Shuja Ur, Kolanu, Nikhil Deep, Mushtaq, Muhammad Muaz, Ali, Husnain, Ahmed, Zeeshan, Mushtaq, Maham, Liaqat, Maryyam, Sarwer, Muhammad Asad, Bokhari, Syed Faqeer Hussain, Ahmed, Fazeel, Bakht, Danyal
Format: Article
Language:English
Subjects:
Antidiabetics
Case reports
Clinical medicine
Creatinine
Diabetes
Endocrinology/Diabetes/Metabolism
GLP-1 receptor agonists
Glucagon
Internal Medicine
Intervention
Kidney diseases
Nephrology
Observational studies
Peptides
Systematic review
Urine
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Summary:Diabetic kidney disease (DKD) is a prevalent microvascular complication of diabetes, posing a significant health burden. Semaglutide, a glucagon-like peptide-1 receptor agonist, has shown promise in mitigating renal outcomes in DKD. This systematic review aimed to evaluate the renal effects of semaglutide in individuals with DKD. A comprehensive literature search identified six eligible studies, including two case reports and four cohorts, from diverse geographic locations. The primary outcomes assessed were changes in estimated glomerular filtration rate (eGFR) and albuminuria. Secondary outcomes included acute kidney injury (AKI) incidence and other renal biomarkers. The impact of semaglutide on eGFR was variable, with some studies reporting decreases and others showing improvements or no significant changes. Albuminuria, however, was more consistently reduced, particularly in patients with macroalbuminuria. Notably, the case reports described semaglutide-associated AKI, including acute interstitial nephritis, highlighting the need for careful monitoring during therapy. Beyond renal outcomes, semaglutide consistently improved glycemic control and promoted weight loss, with generally manageable gastrointestinal side effects. The findings suggest that semaglutide may effectively reduce albuminuria in DKD, potentially slowing disease progression. However, the risk of AKI and the variable impact on eGFR underscore the need for a personalized approach and vigilant monitoring, particularly in patients with advanced CKD. Future large-scale, long-term randomized controlled trials are warranted to definitively assess the renal benefits and risks of semaglutide in DKD.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.64038