Abstract
Disclosure: D. Rizwan: None. M. Kakakhel: None. H. Ahmad: None. U. Hasana: None. S. Umbreen: None. D. Jaffar: None. M. Ahmad: None. H. Jawad: None. R. Qasim: None. L.A. Shaikh: None. P. Kumar: None. K. khan: None. H. Ilyas: None. M. Haider: None. I. Ahmad: None. A. Akram: None. Background and Objective: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has shown potential renal protective effects in previous cardiovascular studies and holds promise in slowing the progression of chronic kidney disease (CKD) in patients with Type 2 diabetes. Several clinical trials have reported significant improvements in glycemic control, reductions in albuminuria, and weight loss, all of which are critical factors in preventing kidney damage. The aim of our study is to further analyze the efficacy of Semaglutide in CKD patients with Type 2 Diabetes. Methodology: We conducted a comprehensive systematic review of randomized controlled trials and observational studies by searching PubMed, Cochrane, and Web of Science databases from their inception until November 3, 2024. The process included study selection, quality assessment, and data extraction. Our primary outcomes of interest were adverse events, adverse kidney events, major cardiovascular events, urine albumin-to-creatinine ratio (UACR), serum creatinine, HbA1c, estimated glomerular filtration rate (eGFR), weight loss, mean systolic blood pressure (MSBP), and mean diastolic blood pressure (MDBP). Statistical analysis was carried out using Review Manager 5.2 meta-analysis software. This study is also registered with Prospero (CRD42024603838). Results: A total of four studies involving 3,895 patients with T2DM and CKD were included in the meta-analysis, comprising three randomized controlled trials and one retrospective cohort study. Semaglutide significantly reduced weight (-2.34 kg, 95% CI [-4.14, -0.54], p=0.01), UACR (-0.28mg/g, 95% CI [-0.46, -0.10], p=0.003), major cardiovascular events (OR 0.82, 95% CI [0.71, 0.95], p=0.007), HbA1c (-0.68%, 95% CI [-0.91, -0.46], p<0.00001), and adverse kidney events (OR 0.77, 95% CI [0.65, 0.90], p=0.001).The reductions in systolic blood pressure (-4.54 mmHg, p=0.06) and serum creatinine (-0.09mg/dL, p=0.06) showed favorable trends but they were not statistically significant. There was no significant improvement observed in Diastolic Blood Pressure, eGFR or Adverse events. Despite the variations in heterogeneity across outcomes, the results predominantly favored Semaglutide in managing critical parameters in patients with CKD and T2DM. Conclusion: Semaglutide displayed notable benefits in reducing weight, UACR, HbA1c, cardiovascular events, and adverse kidney events in patients with T2DM and CKD. While some parameters showed favorable trends without achieving statistical significance, the overall findings highlight the potential of Semaglutide as a therapeutic option. These results support Semaglutide as a promising approach for these comorbidities. Presentation: Monday, July 14, 2025