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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Dec 25, 2025; 14(4): 109457
Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.109457
Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.109457
Cardio-kidney-metabolic protective effects of semaglutide across the spectrum of chronic kidney disease
Harry Economos, Richard J MacIsaac, Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, Melbourne 3065, Victoria, Australia
Richard J MacIsaac, Department of Medicine, The University of Melbourne, Melbourne 3010, Australia
Richard J MacIsaac, Australian Centre for Accelerating Diabetes Innovations, The University of Melbourne, Victoria, Melbourne 3010, Australia
Author contributions: Economos H was the first author and was responsible for the majority of the review’s literature review, writing and drafting; MacIsaac RJ provided the conceptualisation, supervision, contributed substantially to writing and critical revisions, and assisted in finalising the manuscript.
Conflict-of-interest statement: Economos H had no conflicts to declare. MacIsaac RJ has received research grants from Novo Nordisk, Servier, Medtronic, The Rebecca Cooper Medical Research Foundation, St Vincent’s Research Foundation, The Juvenile Diabetes Research Foundation, Grey Innovations, The Diabetes Australia Research Trust/Program and The National Health and Medical Research Council of Australia. Also received honoraria for lectures from Eli Lilly, Novo Nordisk, Sanofi Aventis, Astra Zeneca, Merck Sharp & Dohme, Norvartis, and Boehringer Ingelheim, and has been or is on the advisory boards for Novo Nordisk, Boehringer Ingelheim-Eli Lilly Diabetes Alliance, Astra Zeneca, and Merck Shape and Dohme. Travel support has been supplied by Novo Nordisk, Sanofi, Boehringer Ingelheim and Astra Zeneca. Has been a principal investigator for industry-sponsored clinical trials run by Novo Nordisk, Sanofi, Bayer, Johnson-Cilag and Abbive. He has been an investigator on industry-sponsored trials involving liraglutide, semaglutide, canagliflozin, sotagliflozin, and finerenone.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Richard J MacIsaac, Director, Professor, Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, 4th Floor, Daly Wing, 35 Victoria Parade, PO Box 2900, Fitzroy 3065, Victoria, Australia. r.macisaac@unimelb.edu.au
Received: May 12, 2025
Revised: June 23, 2025
Accepted: September 26, 2025
Published online: December 25, 2025
Processing time: 225 Days and 18 Hours
Revised: June 23, 2025
Accepted: September 26, 2025
Published online: December 25, 2025
Processing time: 225 Days and 18 Hours
Core Tip
Core Tip: In people with type 2 diabetes and chronic kidney disease, semaglutide, saves kidneys, hearts and lives. The glucagon-like peptide-1 receptor agonist (GLP-1RA) class of medications are now being proposed as the fourth pillar of diabetic kidney disease therapy, along with renin-angiotensin-aldosterone system blocking agents, sodium glucose co-transporter-2 inhibitors, and finerenone. We await definitive evidence to support a kidney protective effect of GLP-1RAs outside of the setting of diabetes.