대한신장학회

논문분류	춘계학술대회 초록집
제목	Reduced Kidney Function Decline with Semaglutide Across Kidney Risk Categories: Analyses From the FLOW Trial
저자	Jihyun Kim
출판정보	2026; 2026(1):
키워드	kidney risk categories, eGFR decline, eGFR slope, Semaglutide, FLOW trial
초록	Objectives: In FLOW trial, semaglutide 1.0mg reduced risk of sustained ≥50% eGFR decline, kidney failure, and kidney or cardiovascular death vs. placebo in participants with type 2 diabetes and chronic kidney disease and also reduced total eGFR slope by 1.16(95% CI 0.86, 1.47)mL/min/1.73m2/year. The objective of analysis was to assess effects of semaglutide versus placebo on eGFR slope by severity of CKD at baseline. Methods: CKD severity was analysed by baseline kidney risk using eGFR categories(≤45, >45–<60, and ≥60 mL/min/1.73m2), UACR(<300,≥300–<1000,≥1000–<2000,and ≥2000mg/g), and KDIGO risk category(low/moderate, high, and very high). Slopes were analysed as acute eGFR change(baseline to 12 weeks), chronic eGFR slope(12 weeks to end-of-trial[EOT]), and total eGFR slop(baseline to EOT). eGFR was calculated using CKD-EPI formulas for creatinine and cystatin C. Results: Among 3,533 randomised participants, baseline eGFR, UACR, and KDIGO risk data were available for 1,766(99.9%) in semaglutide group and 1,766(100%) in placebo group. Placebo-corrected preservation of creatinine-based eGFR slope by semaglutide was statistically significant when analysed as chronic(estimated treatment difference[ETD][95% CI] 0.94 mL/min/1.73m²/year[0.62, 1.26]; p<0.0001) and total slope(ETD[95% CI] 1.16mL/min/1.73m²/year[0.86, 1.47]; p<0.0001) measures. Effects were consistent using cystatin C. Acute eGFR slope was not different between treatment groups. The effect of semaglutide on creatinine-based eGFR slope preservation was consistent across baseline eGFR categories(interaction p value[pint] for chronic slope=0.162; total slope pint=0.407) and baseline KDIGO risk categories(chronic slope pint=0.444; total slope pint=0.231). Cystatin C-based eGFR slope preservation was also consistent across baseline eGFR and KDIGO risk subgroups. Across baseline UACR subgroups, there was heterogeneity in creatinine- and cystatin C-based eGFR total and chronic slope preservation, which was largely driven by greater eGFR preservation with semaglutide in participants with baseline UACR >2000mg/g. Conclusion: Semaglutide reduced eGFR decline compared with placebo by a clinically substantial degree. Benefits of semaglutide on eGFR slope were similar across kidney risk categories and eGFR estimation methods.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정