Semaglutide in patients with kidney failure and obesity undergoing dialysis and wishing to be transplanted: A prospective, observational, open‐label study
Open accessAbstract
Aims: Chronic kidney disease (CKD) and obesity are major global health challenges, eventually leading to kidney replacement therapy (KRT), but body mass index (BMI) thresholds hinder kidney transplantation. Glucagon‐like peptide‐1 receptor agonists induce weight loss, thereby offering attractive treatment options; however, their safety and efficacy have not been systematically investigated in patients undergoing dialysis. Materials and Methods: We conducted a prospective 12‐week, open‐label trial with 13 patients who had a BMI ≥ 30.00 kg/m 2 , were undergoing dialysis (12 haemodialysis and 1 peritoneal dialysis) and had not been listed for transplantation due to their weight. Semaglutide was administered once weekly subcutaneously, and the dose was increased from 0.25 mg to 0.5 mg and then to 1 mg. Study endpoints included change in body weight and BMI (primary – statistically evaluated by repeated measures analysis of variance [ANOVA]), side effects, adverse events, blood parameters and patient‐reported outcomes (secondary). Results: At baseline, the mean age ± standard deviation of patients was 64.0 ± 6.4 years, the mean weight was 113.9 ± 16.6 kg, and the mean BMI was 37.3 ± 3.9 kg/m 2 . At week 12, average weight reduction under semaglutide treatment was 4.6 ± 2.4 kg and ranged from 2.0 to 9.7 kg ( p < 0.001 for weight and BMI reduction across the study period). One patient discontinued treatment due to nausea/vomiting, two patients died of unrelated causes and six patients reported side effects. Approximately 9 months after the treatment started, three patients were able to seriously reconsider being listed for transplantation. Conclusions: Semaglutide treatment resulted in significant reduction in weight and BMI in patients with obesity undergoing dialysis, while maintaining an acceptable side effect profile comparable to that of the non‐dialysis population.
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Semaglutide up to 1 mg once weekly is safe in dialysis patients with obesity.
“Semaglutide up to 1 mg OW was found to be safe in dialysis patients with obesity in a prospective observational study, but its use remains not permitted in clinical practice for this population [18].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [18]
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- Authors
- Vanek, L., Kurnikowski, A., Krenn, S., Mussnig, S., & Hecking, M.
- Affiliations
- Medical University of Vienna (AT)
- AIT Austrian Institute of Technology GmbH (AT)
- Klinikum Weiden (DE)
- Corresponding author
- Hecking, Manfred
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2024-10-07
- Volume
- 26
- Issue
- 12
- Pages
- 5931-5941
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W4403237638
- Cited by
- 28
- References
- 11
- Citations by year
- 2026: 9 · 2025: 19
- FWCI
- 7.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Vienna Science and Technology Fund (LS20‐079)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- semaglutide, obesity, renal failure, dialysis, kidney transplantation, GLP-1 receptor agonists, weight loss, body mass index, hemodialysis, peritoneal dialysis, adverse events, patient-reported outcomes
- MeSH terms
- Semaglutide, Aged, Glucagon-Like Peptides, Female, Renal Dialysis, Humans, Hypoglycemic Agents, Kidney Failure, Chronic, Male, Middle Aged, Obesity, Prospective Studies, Weight Loss, Body Mass Index, Kidney Transplantation, Treatment Outcome
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