GLP-1 receptor agonists protect kidney function in people without diabetes.
- Current status
- ProbableEvidence strengthening · Kidney
- Why
- In SELECT (no diabetes, obesity + CVD) a prespecified analysis found the composite kidney endpoint reduced (1.8% vs 2.2%; HR 0.78, 95% CI 0.63-0.96) and a slower eGFR decline; this single secondary analysis is the only direct evidence in people without diabetes. FLOW established kidney protection in type 2 diabetes with CKD and is context, not a test; a meta-analysis found SELECT consistent with the diabetes trials but adds no other non-diabetic data. Evidence in normal-weight people without CVD does not exist.
- What would change it
- A kidney-outcome trial in non-diabetic CKD without obesity.
- Linked studies
- 4 · 1 supports · 1 consistent, but doesn't test the claim · 2 doesn't directly test the claim
- Last updated
- Oct 19, 2026
The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.
The evidence, sorted by what it shows
Supports (1)
- Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trialRandomized trial · 2024 · Study tier 2 · Different population · Benefit · Industry funded
SELECT kidney analysis: HR 0.78 for composite kidney endpoint in obesity without diabetes; low absolute rates (1.8% vs 2.2%).
Consistent, but doesn't test the claim (1)
- Effects of GLP-1 receptor agonists on kidney and cardiovascular disease outcomes: a meta-analysis of randomised controlled trialsMeta-analysis · 2025 · Study tier 1 · Different population · Benefit
Meta-analysis of 11 RCTs, all in type 2 diabetes except SELECT, which was added post hoc: composite kidney outcome HR 0.82 in type 2 diabetes and 0.81 with SELECT included, with no evidence of heterogeneity between SELECT and the diabetes trials. Its only non-diabetic data are SELECT, already linked separately.
Doesn't directly test the claim (2)
- Effects of Semaglutide on Body Composition and GFR: A Prespecified Analysis of the SMART TrialRandomized trial · 2026 · Study tier 3 · Different population · Mixed · Industry funded
Prespecified 24-week analysis in 101 adults with CKD and overweight/obesity without diabetes: body weight fell 9.1 kg versus placebo, lean mass change was -2.5 kg (95% CI -6.6 to 1.6) and fat mass -3.9 kg (95% CI -7.8 to 0.0), and none of these changes correlated with eGFR or measured GFR.
- Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 DiabetesRandomized trial · 2024 · Study tier 1 · Different population · Benefit · Industry funded
FLOW: HR 0.76 for major kidney events in T2D+CKD; stopped early for efficacy (may overestimate).
How this assessment has changed
- ProbableOct 19, 2026 · Evidence strengthening
Owner decision 2026-10-18 on IN-061 (claims audit): recommended options accepted (IN-061.27). Status unchanged; rationale corrected to match the audited links.
- ProbableSep 13, 2026 · Evidence strengthening
initial curated status