This study examined the effect of once-weekly semaglutide 2.4 mg on kidney outcomes in the SELECT trial, which previously showed a 20% reduction in major adverse cardiovascular events with semaglutide versus placebo in overweight/obese patients with established cardiovascular disease but without diabetes. The incidence of the main composite kidney endpoint (death from kidney disease, initiation of chronic kidney replacement therapy, eGFR <15 ml/min/1.73 m², ≥50% reduction in eGFR, or persistent macroalbuminuria) was lower with semaglutide (1.8%) than placebo (2.2%), with a hazard ratio of 0.78 (P=0.02). Semaglutide also showed a treatment benefit for eGFR at 104 weeks, particularly in patients with baseline eGFR <60 ml/min/1.73 m². These findings suggest a potential benefit of semaglutide on kidney outcomes in overweight/obese individuals without diabetes.

Helen M. Colhoun, Ildiko Lingvay, Paul M. Brown, John Deanfield, Kirstine Brown-Frandsen, Steven E. Kahn, Jorge Plutzky, Koichi Node, Alexander Parkhomenko, Lars Rydén, John P. H. Wilding, Johannes F. E. Mann, Katherine R. Tuttle, Thomas Idorn, Naveen Rathor, A. Michael Lincoff