Diabetic Kidney Disease — Semaglutide Flows into the Mainstream

This editorial discusses the pivotal role of semaglutide, a GLP-1 receptor agonist, in managing diabetic kidney disease (DKD) based on findings from the FLOW trial. The trial demonstrated a 24% reduction in the composite primary outcome (kidney failure, sustained eGFR decline, or kidney/cardiovascular death) with semaglutide compared to placebo, alongside cardiovascular benefits. Unlike RAS inhibitors or SGLT2 inhibitors, semaglutide showed a distinct eGFR slope pattern without an initial dip, suggesting unique renoprotective mechanisms. The authors advocate for integrating semaglutide with existing therapies (e.g., SGLT2 inhibitors, finerenone) to mitigate DKD progression, highlighting its tolerability and broader potential for non-diabetic chronic kidney disease populations.

This editorial discusses the pivotal role of semaglutide, a GLP-1 receptor agonist, in managing diabetic kidney disease (DKD) based on findings from the FLOW trial. The trial demonstrated a 24% reduction in the composite primary outcome (kidney failure, sustained eGFR decline, or kidney/cardiovascular death) with semaglutide compared to placebo, alongside cardiovascular benefits. Unlike RAS inhibitors or SGLT2 inhibitors, semaglutide showed a distinct eGFR slope pattern without an initial dip, suggesting unique renoprotective mechanisms. The authors advocate for integrating semaglutide with existing therapies (e.g., SGLT2 inhibitors, finerenone) to mitigate DKD progression, highlighting its tolerability and broader potential for non-diabetic chronic kidney disease populations.