Semaglutide safely reduces BMI, blood pressure, and improves renal function in non-diabetic obesity with CKD
Background
Patients with non-diabetic obesity and chronic kidney disease (CKD) face high cardiometabolic risk and limited therapeutic options. While semaglutide, a GLP-1 receptor agonist, has shown metabolic and renal benefits in diabetic populations, its efficacy and safety in non-diabetic individuals with this specific comorbidity profile have remained largely unstudied. Addressing this gap is crucial for expanding effective treatment strategies beyond glycemic control.
Study Design
This systematic review and meta-analysis followed PRISMA guidelines, screening 580 studies to include 3 eligible studies (total n=430 participants). The included studies comprised a randomized controlled trial, a real-world observational dialysis study, and a large post hoc trial analysis. Fixed-effect meta-analysis models were applied to estimate pooled effects on BMI, systolic blood pressure (SBP), and renal outcomes, comparing semaglutide treatment arms against control groups.
Results
Semaglutide treatment significantly reduced BMI (mean reduction: Tuttle 18.3%, Apperloo 11.8%, Vanek 1.5%; P = 0.001). Hypertension control also improved, with SBP <130 mmHg achieved in Apperloo (20.6%), Vanek (12.5%), and Tuttle (17.6%) study participants (P < 0.02). No publication bias was detected across the included studies, reinforcing the consistency of these positive findings.
Renal function significantly improved, with
eGFR>30 ml/min/1.73m² increasing from baseline in all studies (Apperloo 65.8%, Vanek 4.83%, Tuttle 36.4%; P < 0.001).
Key Findings
- Semaglutide significantly reduced BMI (mean reduction up to 18.3%; P = 0.001).
- Hypertension control improved, with SBP <130 mmHg achieved in up to 20.6% more participants (P < 0.02).
- Renal function improved, with
eGFR>30 ml/min/1.73m² increasing from baseline in all studies (up to 65.8%; P < 0.001). - Semaglutide was well-tolerated in non-diabetic patients with obesity and CKD.
- No publication bias was detected across the included studies.
Why It Matters
These findings significantly expand the potential application of semaglutide beyond its established use in diabetes, offering a new therapeutic avenue for non-diabetic patients with obesity and CKD, including those on dialysis. Clinicians can now consider semaglutide for weight management and renal protection in this high-risk population. This supports its expanded use in protocols targeting cardiometabolic syndrome components, potentially reducing the burden of kidney disease progression and cardiovascular events. The data suggests a tangible benefit for improving key health markers in a challenging patient group.
semaglutide
obesity
ckd
hypertension
meta-analysis
renal-health