Post hoc analysis of the SUSTAIN 6 trial showed that once-weekly semaglutide improved kidney disease outcomes across all KDIGO risk categories in patients with type 2 diabetes and cardiovascular disease.
All KDIGO risk categoriesSemaglutide showed kidney-protective effects regardless of baseline kidney disease severity in SUSTAIN 6
What the researchers found
Once-weekly semaglutide improved kidney disease outcomes consistently across all KDIGO risk categories in SUSTAIN 6 participants with T2D and cardiovascular disease or high CV risk.
Why it matters
Kidney disease is a leading complication of diabetes. This analysis provides evidence that semaglutide's kidney benefits extend across the full spectrum of kidney disease severity — supporting its use even in patients who already have significant kidney impairment.
The numbers in context
Post hoc analysis of SUSTAIN 6 trial; kidney outcomes assessed across all KDIGO risk categories; compared once-weekly semaglutide vs. placebo.
How the study worked
Post hoc analysis of the SUSTAIN 6 randomized controlled trial, stratifying participants by KDIGO risk category to assess semaglutide's effects on kidney disease outcomes and KDIGO risk category transitions vs. placebo.
Who was studied
Type 2 diabetes patients across all KDIGO kidney disease risk categories
What this study cannot tell us
Post hoc analysis — not the primary trial endpoint. SUSTAIN 6 was designed for cardiovascular outcomes, not kidney endpoints. Subgroup analyses may lack power for individual KDIGO categories. Median follow-up of ~2 years may miss long-term kidney effects.
How to read the evidence
Strong evidence — derived from a large, well-designed RCT (SUSTAIN 6), though the kidney analysis is post hoc rather than a pre-specified primary endpoint.
When this study was published
Published in 2024. Builds on SUSTAIN 6 trial data with kidney-focused reanalysis. Complements the 2024 FLOW trial results.
The bigger picture
GLP-1 receptor agonists are emerging as multi-organ protective agents — not just blood sugar and weight loss drugs. This kidney analysis, combined with cardiovascular data from SUSTAIN 6 and the dedicated renal outcomes trial FLOW, positions semaglutide as a foundational therapy for diabetic patients at cardiorenal risk.
Questions still open
- How do semaglutide's kidney benefits in SUSTAIN 6 compare to the dedicated FLOW renal outcomes trial?
- Should KDIGO guidelines upgrade GLP-1RAs from risk-based to universal recommendation in diabetic kidney disease?
- Do higher semaglutide doses (2.4 mg) provide additional kidney protection beyond the 1.0 mg dose studied?
Common questions
Can semaglutide protect the kidneys in people with diabetes?
Should people with kidney disease still take semaglutide?
Read the original research
Effects of Once-Weekly Semaglutide on Kidney Disease Outcomes by KDIGO Risk Category in the SUSTAIN 6 Trial.
Kidney international reports, 9(7), 2006-2015
Citation
Tuttle, Katherine R; Bain, Stephen C; Bosch-Traberg, Heidrun; Khunti, Kamlesh; Rasmussen, Søren; Sokareva, Ekaterina; Cherney, David Z. (2024). Effects of Once-Weekly Semaglutide on Kidney Disease Outcomes by KDIGO Risk Category in the SUSTAIN 6 Trial.. Kidney international reports, 9(7), 2006-2015. https://doi.org/10.1016/j.ekir.2024.04.028