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. 2025 Mar 27;87(4):2278-2285.
doi: 10.1097/MS9.0000000000003126. eCollection 2025 Apr.

A meta-analytic review of the safety and efficacy of semaglutide in type 2 diabetes mellitus and chronic kidney disease patients

Taimoor Ashraf  1 , Shevita Bai  2 , Aashish Kumar  2 , Raja Subhash Sagar  3 , Fnu Saloni  2 , Anesh Kumar  4 , Rohet Kumar  5 , Ashvin Pahwani  4 , Vikash Kumar  4 , Muhammad Hassaan  6 , Govinda Khatri  6 , Maheen Jabbar  7 , Fnu Deepak  5 , Salih Abdella Yusuf  8
Affiliations

A meta-analytic review of the safety and efficacy of semaglutide in type 2 diabetes mellitus and chronic kidney disease patients

Taimoor Ashraf et al. Ann Med Surg (Lond). .

Abstract

Background: Type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) frequently coexist, posing a significant challenge due to increased risks of cardiovascular disease and mortality. Glucagon-like peptide-1 receptor agonists, such as semaglutide, have demonstrated potential for enhancing glucose control and reducing cardiovascular and renal risks.

Methods: Randomized controlled trials (RCTs) were taken to compare semaglutide with placebo or standard care in adults with T2DM and CKD. Key outcomes assessed included cardiovascular mortality, major adverse cardiovascular events (MACE), kidney-related adverse events, all-cause mortality, and hospitalization rates.

Results: Three RCTs involving 10 013 patients were included. Semaglutide demonstrated a 29% reduction in cardiovascular mortality (risk ratio [RR]: 0.71; 95% confidence interval [CI]: 0.52-0.97; P = 0.03; I 2 = 59%) and a 20% reduction in MACE (RR: 0.80; 95% CI: 0.71-0.91; P = 0.0007; I 2 = 0%). A significant 20% decrease in kidney-related adverse events was observed (RR: 0.80; 95% CI: 0.71-0.89; P < 0.0001; I 2 = 0%), and semaglutide also reduced the need for cardiovascular medications (RR: 0.86; 95% CI: 0.81-0.91; P < 0.00001; I 2 = 13%).

Conclusion: Semaglutide shows promise as a therapeutic option for T2DM patients with CKD, significantly improving cardiovascular and renal outcomes. Its integration into treatment regimens for high-risk patients may enhance clinical outcomes and reduce treatment complexity. However, more extensive and longer-term studies are needed to confirm these findings.

Keywords: GLP-1 receptor agonist; cardiovascular events; chronic kidney disease; kidney events; meta-analysis; mortality; semaglutide; type 2 diabetes.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. There was no conflict of interest among authors.

Figures

Figure 1.
Figure 1.
A: Prisma flowchart. B: Risk of bias graph. C: Risk of bias summary.
Figure 2.
Figure 2.
Cardiovascular mortality.
Figure 3.
Figure 3.
Major adverse cardiovascular events.
Figure 4.
Figure 4.
Major kidney adverse events.
Figure 5.
Figure 5.
Nonfatal myocardial infarction.
See this image and copyright information in PMC

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