Semaglutide in type 2 diabetes with chronic kidney disease at high risk progression—real-world clinical practice

Autor: Beatriz Aviles Bueno, Maria Jose Soler, Luis Perez-Belmonte, Anabel Jimenez Millan, Francisco Rivas Ruiz, Maria Dolores Garcia de Lucas
Přispěvatelé: Institut Català de la Salut, [Aviles Bueno B] Costa del Sol Hospital, Nephrology Department, Málaga, Spain. [Soler MJ] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Perez-Belmonte L] Regional University Hospital and Biomedical Research Institute, Internal Medicine Department Málaga, Spain. [Jimenez Millan A] Puerto Real University Hospital, Endocrinology Department, Cádiz, Spain. [Rivas Ruiz F] Costa del Sol Hospital, Internal Medicine Department, Málaga, Spain. [Garcia de Lucas MD] Research Unit, Marbella, Málaga, Spain, Vall d'Hebron Barcelona Hospital Campus
Rok vydání: 2022
Předmět:
obesity
enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo de la glucosa::diabetes mellitus::diabetes mellitus tipo II [ENFERMEDADES]
Transplantation
semaglutide
Other subheadings::Other subheadings::/agonists [Other subheadings]
Amino Acids
Peptides
and Proteins::Proteins::Membrane Proteins::Receptors
Cell Surface::Receptors
G-Protein-Coupled::Glucagon-Like Peptide Receptors::Glucagon-Like Peptide-1 Receptor [CHEMICALS AND DRUGS]
Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus::Diabetes Mellitus
Type 2 [DISEASES]
Male Urogenital Diseases::Urologic Diseases::Kidney Diseases [DISEASES]
Enteroglucagó - Receptors
GLP-1RA
diabetic chronic disease
albuminuria
aminoácidos
péptidos y proteínas::proteínas::proteínas de membranas::receptores de superficie celular::receptores acoplados a proteínas G::receptores del péptido similar al glucagón::receptor del péptido 1 Similar al glucagón [COMPUESTOS QUÍMICOS Y DROGAS]
Nephrology
Otros calificadores::Otros calificadores::/agonistas [Otros calificadores]
Diabetis no-insulinodependent - Tractament
enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales [ENFERMEDADES]
Ronyons - Malalties - Tractament
Zdroj: Scientia
ISSN: 2048-8513
2048-8505
DOI: 10.1093/ckj/sfac096
Popis: Background Semaglutide [glucagon-like peptide-1 receptor-agonist (GLP-1RA)] has shown nephroprotective effects in previous cardiovascular studies. However, its efficacy and safety in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) have been rarely studied. Methods This is a multicenter, retrospective, observational study in patients with T2D and CKD with glycosylated hemoglobin A1c (HbA1c) of 7.5–9.5% treated with subcutaneous semaglutide for 12 months in real-world clinical practice. The main objectives were glycemic control as HbA1c 5%. Results We studied a total of 122 patients, ages 65.50 ± 11 years, 62% men, duration of T2D 12 years, baseline HbA1c 7.57% ± 1.36% and an estimated glomerular filtration rate (eGFR) 50.32 ± 19.21 mL/min/1.73 m2; 54% had a urinary albumin:creatinine ratio (UACR) of 30–300 mg/g and 20% had a UACR >300 mg/g. After 12 months of follow-up, HbA1c declined −0.73% ± 1.09% (P < .001), with 57% of patients achieving values 5% of their body weight. Systolic and diastolic blood pressure decreased −9.85 mmHg and −5.92 mmHg, respectively (P < .001). The mean UACR decreased 51% in the group with baseline macroalbuminuria (UACR >300 mg/g). The mean eGFR (by the Chronic Kidney Disease Epidemiology Collaboration) remained stable. The need for basal insulin decreased 20% (P < .005). Only 7% of patients on insulin had mild hypoglycemic episodes. Semaglutide was stopped in 5.7% of patients for digestive intolerance. Conclusions In this real-world study, patients with T2D and CKD treated with subcutaneous semaglutide for 12 months significantly improved glycemic control and decreased weight. Albuminuria decreased by >50% in patients with macroalbuminuria. The administration of GLP-1RA in patients with T2D and CKD was safe and well tolerated.
Databáze: OpenAIRE
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