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Kidney Week

Abstract: SA-PO1157

FLOW: Effects of Semaglutide on Kidney Failure Using the Kidney Failure Risk Equation

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • L, Sreenivasamurthy, Lifecare Hospital and Research Centre, Bangalore, India
  • Arici, Mustafa, Hacettepe University, Faculty of Medicine, Ankara, Turkey
  • Bax, Willem A., Northwest Clinics Alkmaar, Alkmaar, Netherlands
  • Busch, Robert S., Albany Medical College, Albany, New York, United States
  • Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Gorriz, Jose L., Hospital Clíníco Universitario, Valencia, Spain
  • Gumprecht, Janusz, Medical University of Silesia, Katowice, Poland
  • Idorn, Thomas, Novo Nordisk A/S, Søborg, Denmark
  • Mahaffey, Kenneth W., Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, United States
  • Mann, Johannes F., KfH Kidney Centre, München, Germany
  • Mayrdorfer, Manuel, Novo Nordisk A/S, Søborg, Denmark
  • Baastrup Nordsborg, Rikke, Novo Nordisk A/S, Søborg, Denmark
  • Pratley, Richard E., AdventHealth Translational Research Institute, Orlando, Florida, United States
  • Pugliese, Giuseppe, University of Rome, Rome, Italy
  • Rasmussen, Daniel Guldager Kring, Novo Nordisk A/S, Søborg, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark
  • Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
  • Tuttle, Katherine R., University of Washington Division of Nephrology, Seattle, Washington, United States
  • Perkovic, Vlado, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia

Group or Team Name

  • The FLOW Trial Investigators.
Background

In FLOW, once-weekly subcutaneous semaglutide 1.0 mg reduced the risk of major kidney outcomes in people with type 2 diabetes and chronic kidney disease. This post hoc analysis evaluated the effect of semaglutide on risk of kidney failure using the kidney failure risk equation (KFRE).

Methods

Participants received semaglutide or placebo. The main outcome of this analysis was the 5-year risk of kidney failure (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2 or kidney replacement therapy) predicted with the four-variable KFRE, using creatinine-based eGFR (calculated using CKD-EPI 2009), urine albumin-to-creatinine ratio, age, and sex in a Cox regression model.

Results

In total, 3533 participants were followed for (median) 3.4 years. At baseline, mean (standard deviation) KFRE scores were 0.12 (0.17) and 0.11 (0.15) in semaglutide and placebo arms, respectively. KFRE scores increased over time in both arms but were consistently lower for semaglutide (Figure A). Separation of semaglutide and placebo arms was observed from week 26, and at week 104, the estimated treatment difference was −0.06 (95% confidence interval −0.07, −0.05; p<0.0001). Modest concordance (C-index=0.58) was observed between the predicted event rate for time to kidney failure and KFRE score at baseline (Figure B).

Conclusion

Predicted risk of kidney failure increased less with semaglutide vs placebo during the FLOW trial, supporting the results of the primary FLOW analyses.

Funding

  • Commercial Support – The FLOW trial was funded by Novo Nordisk A/S

Digital Object Identifier (DOI)