Kidney Week

Abstract: TH-PO0368

Kidney, Cardiovascular, and Death Outcomes with Semaglutide Treatment Among Two Race and Two Ethnic Groups: Post Hoc Analysis from the FLOW Trial

Session Information

• Diabetic Kidney Disease: From Early Biomarkers to Novel Therapeutic Targets
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Mende, Christian W., University of California San Diego, La Jolla, California, United States

Christian W. Mende, MD, FASN

• Campos, Carlos, Carlos Campos Primary Care & Diabetes Care, New Braunfels, Texas, United States

Carlos Campos, MD

• Pratley, Richard E., AdventHealth Translational Research Institute, Orlando, Florida, United States

Richard E. Pratley, MD

• Tuttle, Katherine R., Providence Medical Research Center, Spokane, Washington, United States

Katherine R. Tuttle, MD, FASN

• Mehanna, Sherif, Novo Nordisk Inc, Plainsboro, New Jersey, United States

Sherif Mehanna, MD

• Swift, Caroline, Novo Nordisk Inc, Plainsboro, New Jersey, United States

Caroline Swift, PhD, MPH

• Rasmussen, Soren, Novo Nordisk A/S, Søborg, Capital Region of Denmark, Denmark

Soren Rasmussen, PhD

• Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Peter Rossing, MD, DrMed

• Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia

Vlado Perkovic, MBBS, PhD, FASN

• Mahaffey, Kenneth W., Stanford Center for Clinical Research, Stanford, California, United States

Kenneth W. Mahaffey, MD

Background

Therapeutic responses to semaglutide may vary across race and ethnic groups among patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). In the FLOW trial (NCT03819153), semaglutide 1 mg reduced risk of kidney outcomes by 24% and all-cause death by 20% compared with placebo in the overall population over a median 3.4 years of follow-up. In this post hoc analysis, we assessed clinical outcomes among two race and two ethnic groups.

Methods

The post hoc analysis included patients aged ≥18 years with CKD and T2D. Patients with race data available were categorized as Black/African American or not Black/African American. Patients with ethnicity data available were categorized as Hispanic/Latino or not Hispanic/Latino. Efficacy of semaglutide 1 mg vs placebo was assessed for 4 outcomes—5-component CKD, major adverse cardiovascular events (MACE), all-cause death, and annual change (total slope) in estimated glomerular filtration rate (eGFR)—by race or ethnicity. Hazard ratios were estimated using Cox regression models stratified by sodium-glucose cotransporter-2 inhibitors (SGLT2i) use at baseline with an interaction term for treatment by race or ethnicity. Change in eGFR was estimated using random effects linear regression with an interaction term for treatment by race or ethnicity, adjusted for SGLT2i use.

Results

Among 3,454 patients with race data, 160 identified as Black/African American. Among 3,388 patients with ethnicity data, 556 identified as Hispanic/Latino. Analyses demonstrated that race or ethnic group did not modify the treatment effect on any outcome (Figure 1; Table 1).

Conclusion

Among patients in FLOW, the effect of semaglutide 1 mg on kidney and cardiovascular outcomes was similar across two race and two ethnic groups.

Funding

• Commercial Support – Novo Nordisk, Inc.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025nztajebj