Abstract: FR-PO0499
Effect of Oral Semaglutide on Residual Albuminuria in Patients with Diabetic Kidney Disease Despite Standard Nephroprotective Therapy
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Igamberdieva, Ranokhon, Tashkent State Medical University, Tashkent, Uzbekistan
- Daminov, Botir, Republican Specialized Scientific and Practical Medical Center of Nephrology and Kidney Transplantation, Tashkent, Uzbekistan
Background
Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated important cardiometabolic benefits in type 2 diabetes, evidence regarding their renal protective effects in diabetic kidney disease (DKD) remains limited. The efficacy of oral semaglutide in patients with persistent macroalbuminuria despite optimized standard-of-care therapy requires further evaluation.
Methods
In this prospective, randomized, placebo-controlled, single-center study, 92 patients with DKD and urinary albumin-to-creatinine ratio (UACR) of 300–3000 mg/g were randomized to receive oral semaglutide 3 mg, semaglutide 7 mg, or placebo for 16 weeks. Assessments were performed every 4 weeks. Background therapy included renin–angiotensin system inhibitors, sodium–glucose cotransporter-2 (SGLT2) inhibitors, and finerenone when clinically indicated.
Results
Baseline median UACR was 572.3 mg/g; 85.8% of patients received renin–angiotensin system inhibitors, 64.1% SGLT2 inhibitors, and 28.2% finerenone. During the 16-week study, both semaglutide groups demonstrated progressive reductions in albuminuria versus placebo. As shown in Figure 1, semaglutide 7 mg produced the greatest UACR reduction, reaching 54% at Week 16, compared with 32% in the semaglutide 3 mg group and 12% with placebo. Placebo-adjusted UACR reductions at Week 16 were 21% for semaglutide 3 mg (p=0.031) and 42% for semaglutide 7 mg (p<0.0001). The 7 mg dose was also associated with greater improvements in HbA1c, body weight, blood pressure, lipid profile, and liver enzymes. Most adverse events were mild-to-moderate gastrointestinal events.
Conclusion
Among patients with DKD and persistent macroalbuminuria despite guideline-directed nephroprotective therapy, oral semaglutide significantly reduced albuminuria and improved multiple cardiometabolic parameters over 16 weeks. These findings support the potential additive renal benefits of GLP-1 receptor agonists in patients already receiving contemporary standard-of-care treatment.