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Case Reports
. 2021 Jan 7;3(2):282-285.
doi: 10.1016/j.xkme.2020.10.008. eCollection 2021 Mar-Apr.

Acute Kidney Injury Associated With Semaglutide

David J Leehey  1   2 , Mohamed A Rahman  3 , Ewa Borys  1 , Maria M Picken  1 , Christina E Clise  4
Affiliations
Case Reports

Acute Kidney Injury Associated With Semaglutide

David J Leehey et al. Kidney Med. .

Abstract

Case reports of acute kidney injury in patients taking the glucagon-like peptide 1 (GLP-1) receptor agonists exenatide and liraglutide have been reported. We report 2 patients with chronic kidney disease due to diabetic kidney disease who experienced rapid worsening of kidney function and increased proteinuria after being prescribed the GLP-1 receptor agonist semaglutide. In 1 patient, kidney biopsy showed advanced diffuse and nodular glomerulosclerosis accompanied by interstitial lymphoplasmacytic and eosinophilic infiltrate and evidence of acute tubular injury. At this time, the long-term outcomes of patients who experience acute kidney injury associated with GLP-1 receptor agonists is not known. We recommend that caution be used with these agents in patients with moderate to severe chronic kidney disease due to limited kidney reserve in the event of an adverse kidney event. Because most adverse kidney events have occurred in patients who experience adverse gastrointestinal symptoms, such patients should have laboratory tests and discontinuation of the medication if there is acute worsening of kidney function.

Keywords: Glucagon-like peptide-1 (GLP-1) receptor agonists; acute kidney injury (AKI); chronic kidney disease (CKD); diabetic kidney disease; diabetic nephropathy; semaglutide.

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Figures

Figure 1
Figure 1
Time course of estimated glomerular filtration rate (eGFR) in patient 1. Before administration of semaglutide, there was a slow decline in eGFR of ∼1.5 mL/min/1.73 m2 per year over a 6-year period. There was a sudden decline in kidney function after administration of semaglutide (double arrow).
Figure 2
Figure 2
(A) Diffuse and nodular glomerulosclerosis and (B) lymphocytic and eosinophilic infiltrate from the kidney biopsy performed in patient 1.
See this image and copyright information in PMC

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