Ozempic found to reduce risk of kidney disease and death in people with diabetes

Semaglutide also slowed down loss of kidney function, lowered systolic blood pressure, and reduced body weight among participants. 

Serious adverse effects were also less common, compared to those experienced by the placebo group, but were still experienced by almost 50 per cent of those on semaglutide, which Prof. Perkovic said was a function of the poor health of those involved in the trial – people with high-risk chronic kidney disease. 

The proven benefits prompted the trial to be cut short, based on a recommendation by an Independent Data Monitoring Committee. 

“It’s the same chemical compound but we used a lower dose ... we did that deliberately because people with kidney disease tend to be more sensitive to the effects and side effects of drugs,” Prof. Perkovic said.

“That’s helpful in terms of being able to perhaps have the drug more widely used than might have otherwise been the case given the current supply limitations.”

Kidney disease on the rise

It’s hoped the findings could soon help the growing number of people with kidney disease, which now affects about 850 million people worldwide, Prof. Perkovic said. 

“One of the most common causes of kidney disease is diabetes, particularly type 2 diabetes, which has also been growing dramatically in recent decades,” he said.  

Chronic kidney diseased contributed to about 20,000 deaths in Australia in 2021, about 12 per cent of all deaths that year, the latest for which figures from the Australian Institute of Health and Welfare are available.

In addition to loss of kidney function, kidney disease increases the risk of a range of other health conditions, particularly heart disease and stroke, and is associated with poorer quality of life.  

“People with kidney disease feel tired, weak and a bit foggy-headed, they often can't think clearly, and their quality of life is therefore dramatically reduced,” Prof. Perkovic said.  

“If they end up on dialysis it affects not just them but their family, because they have to go off and have dialysis several times a week and ... the cost of dialysis is really expensive, it's $100,000 per person per year in Australia or more.”

The challenges ahead for kidney disease

Prof. Perkovic said there has been an increase in treatments for chronic kidney disease in recent years, but more needed to be done. 

“We're really starting to dramatically improve outcomes for people with diabetes and kidney disease. But that will only happen if the results are translated into action at the clinical coalface, so that's an important next step,” he said. 

That will require overcoming supply shortages for semaglutide and the general lag in implementing research in clinical settings. More research is also needed to determine the optimal way to use semaglutide in combination with other existing treatments.

“The challenge is to get these results into clinical practice, to get the drug used by the people who will benefit from it, who will live longer without dialysis, without heart attacks, without strokes, if they take this drug.” 

Novo Nordisk will need to seek regulatory approval for semaglutide to be used to treat those with chronic kidney disease. Prof. Perkovic expected this would be granted, and that semaglutide would become part of guideline-based therapy.