2818-LB: Real-World Evidence on Efficacy and Safety of Semaglutide in Patients with Type 2 Diabetes and Advanced Chronic Kidney Disease

Introduction and Objective: GLP-1 receptor agonists (GLP-1 RAs) have demonstrated cardiovascular and renal benefits in patients with type 2 diabetes mellitus (T2DM). However, data on their use in advanced chronic kidney disease (CKD) remain sparse. This study evaluated the safety and efficacy of semaglutide in patients with T2DM and CKD stages 4-5. Methods: We reviewed 45 patients with T2DM and advanced CKD (stage 4 or 5) who were initiated on semaglutide and followed up for 12 months. Primary endpoints included changes in HbA1c and eGFR from baseline to the last available follow-up. Secondary endpoints included changes in weight, BMI, safety outcomes, and discontinuation rates. Paired analyses were performed using the Wilcoxon signed-rank test, with significance set at p<0.05. Results: The mean age was 69.1 ± 10.9 years, and 57.8% were female. Baseline HbA1c was 8.3 ± 1.7%, eGFR was 25.5 ± 10.2 mL/min/1.73 m², and weight was 77.6 ± 16.6 kg. Semaglutide significantly reduced HbA1c by 0.71% (p < 0.001), while eGFR remained stable (Δ −0.22, p = 0.305), and weight decreased by −0.43 kg (p = 0.496). The discontinuation rate was 13.3%, mainly due to gastrointestinal adverse events (Figure 1). Conclusion: The findings of this study suggest that semaglutide is effective for glycemic control and appears to have an acceptable safety profile in advanced CKD, warranting prospective validation. Disclosure S. Elnour: None. E. Abdelgadir: None. F. Rashid: Speaker's Bureau; Current; Novo Nordisk, Boehringer Ingelheim International GmbH, Bayer AG, Novartis AG. A. Khidir: None. K. Hafidh: None. A. Khalifa: None. F. Alawadi: None. J. Nafach: None.