Research has shown that obesity and cardiovascular disease can increase a person’s risk of developing kidney disease. However, a recent study conducted at the University of Edinburgh in the United Kingdom suggests that semaglutide, an active ingredient in GLP-1 receptor agonist medications, may help protect kidney function in individuals who are overweight or obese with established cardiovascular disease. This study, known as the SELECT trial, involved more than 17,000 participants and found that those receiving semaglutide injections experienced 22% fewer adverse kidney-related events compared to the placebo group after an average follow-up of 3.5 years. The lead author of the study, Prof. Helen M. Colhoun, MD, stated that semaglutide could potentially reduce the risk of kidney-related complications and improve the quality of life for individuals with obesity.
The researchers also examined how semaglutide affected participants’ estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR). Participants who received semaglutide had a significantly lower decline in eGFR compared to those in the placebo group, indicating potential kidney function protection in individuals with pre-existing kidney impairment. Additionally, researchers reported an average 8.1% decrease in UACR with normal albumin levels, a 27.2% decrease in those with microalbuminuria, and a 31.4% decrease in those with macroalbuminuria in participants using semaglutide compared to the placebo group. Prof. Colhoun noted that the observed benefits in eGFR and UACR were encouraging and suggested the potential for enhanced management of kidney complications in the patient population with overweight and obesity without diabetes.
Dr. Mir Ali, a bariatric surgeon and medical director, stated that the findings of the study were not surprising, as weight loss has been shown to improve organ functions in individuals who are significantly overweight. According to Dr. Ali, losing weight can reduce the stress on organs such as the kidneys, heart, lungs, and liver, as well as decrease inflammation associated with obesity. Dr. Cheng-Han Chen, a board-certified interventional cardiologist, emphasized the connection between cardiovascular disease and kidney function, noting that kidney function relies on the heart’s ability to filter blood effectively. He added that cardiovascular disease can negatively impact the blood vessels in the kidneys and affect blood vessel dilation and constriction, ultimately impacting kidney health.
Looking ahead, researchers are interested in exploring whether the improvement in kidney function observed with semaglutide use is independent of weight loss. There is a need for longer-term studies to determine if semaglutide can prevent poor kidney outcomes such as the initiation of dialysis or kidney transplant. Dr. Ali pointed out that recent research has shown semaglutide to improve cardiovascular health independent of weight loss, raising the possibility that it could also protect kidney function regardless of weight loss. He emphasized the importance of continued research into new ways of protecting kidney function in individuals who are obese with heart disease, as kidney disease poses significant morbidity and mortality in the United States. Future studies will be crucial in determining the long-term benefits of semaglutide in preserving kidney function and improving outcomes for individuals with obesity and cardiovascular disease.