Impactos do tratamento com semaglutida na progressão da doença renal crônica em pacientes diabéticos

Abstract

Chronic Kidney Disease (CKD) is a common complication of Diabetes mellitus (DM), resulting from chronic hyperglycemia that damages renal blood vessels. Semaglutide, a GLP-1 receptor agonist, has demonstrated benefits in glycemic control and potential nephroprotective effects. This study aims to evaluate the effects of Semaglutide on the glomerular filtration rate (GFR) and albuminuria in diabetic patients with CKD. Cohort studies, randomized clinical trials, and case-control studies published between 2022 and 2024 in the MEDLINE database were analyzed. The descriptors “semaglutide,” “chronic kidney disease,” and “diabetes” were used, and studies that assessed impacts on GFR and albuminuria in patients with CKD using semaglutide were included. Unrelated or unclear studies were excluded. After applying the inclusion and exclusion criteria, 4 studies were selected. These studies indicated that the use of semaglutide improves glycemic control by reducing inflammatory cytokines and renal oxidative stress, improving glomerular endothelial function, and slowing the progression of CKD. The FLOW clinical trial showed a significant reduction in albuminuria and preservation of GFR. Other studies, such as SUSTAIN 6, also demonstrated stabilization of GFR and decreased albuminuria with subcutaneous semaglutide. However, one study with oral semaglutide indicated a reduction in GFR without a significant impact on albuminuria. Therefore, semaglutide is effective in managing CKD in diabetic patients, promoting improved renal outcomes. However, further studies are needed to reinforce these conclusions.