Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial
- Design
- Randomized trial · 17604 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different populationObesity with CVD, no diabetes; low absolute event rates; kidney benefit in non-diabetic people is notable but the population still had obesity.
- Could weight loss explain it?
- PossiblyNot separated; weight and blood-pressure reduction are plausible mediators.
- Study tier
- Study tier 2Prespecified secondary endpoint of a large RCT with modest event numbers.
- Assessment
- Version 2 · curated · Sep 13, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
In SELECT participants (obesity and heart disease, no diabetes), semaglutide reduced a composite kidney outcome from 2.2% to 1.8% and slowed eGFR decline slightly, more so in those with reduced kidney function. Extends kidney protection beyond diabetes, but not beyond obesity.
01Findings
What the study reported
- Drugs
- Semaglutide
- Dose
- 2.4 mg weekly
- Route
- subcutaneous
- Comparator
- placebo
- Primary outcome
- Prespecified composite kidney endpoint; eGFR change at 104 weeks
- Effect
- Composite 1.8% vs 2.2%, HR 0.78; eGFR benefit 0.75 mL/min/1.73m2 overall, 2.19 in baseline eGFR <60
- 95% confidence interval
- 0.63 to 0.96
- P value
- 0.02
- Follow-up
- mean 3.3 years
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Bmi min
- 27
- Obesity status
- BMI >= 27 required
- Diabetes status
- excluded
- Cvd status
- established CVD
- Sample size
- 8803
Study quality details
- Study design
- Randomized controlled trial
- Sample size
- 8803
- Randomization
- yes
- Blinding
- not stated
- Comparator
- placebo
- Follow up duration
- 104 weeks
- Outcome type
- mixed
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- few kidney events (1.8% vs 2.2%)
- Risk of bias
- prespecified secondary endpoint
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- Novo Nordisk
- Industry funded
- Yes
- Manufacturer
- Novo Nordisk
- Sponsor role
- Sponsor analysed.
- Author conflicts
- One author is a Novo Nordisk employee and shareholder; others report Novo Nordisk relationships.
- Independent replication
- unknown
- Notes
- Authors declare relationships with the drug's manufacturer: Novo Nordisk
Funding is shown on every study and never used to score it.
03Claims
Claims this study bears on
- GLP-1 receptor agonists protect kidney function in people without diabetes.Supports
SELECT kidney analysis: HR 0.78 for composite kidney endpoint in obesity without diabetes; low absolute rates (1.8% vs 2.2%).
04Source
The source, as retrieved
Abstract
The SELECT trial previously reported a 20% reduction in major adverse cardiovascular events with semaglutide (n = 8,803) versus placebo (n = 8,801) in patients with overweight/obesity and established cardiovascular disease, without diabetes. In the present study, we examined the effect of once-weekly semaglutide 2.4 mg on kidney outcomes in the SELECT trial. The incidence of the pre-specified main composite kidney endpoint (death from kidney disease, initiation of chronic kidney replacement therapy, onset of persistent estimated glomerular filtration rate (eGFR) < 15 ml min-1 1.73 m-2, persistent ≥50% reduction in eGFR or onset of persistent macroalbuminuria) was lower with semaglutide (1.8%) versus placebo (2.2%): hazard ratio (HR) = 0.78; 95% confidence interval (CI) 0.63, 0.96; P = 0.02. The treatment benefit at 104 weeks for eGFR was 0.75 ml min-1 1.73 m-2 (95% CI 0.43, 1.06; P < 0.001) overall and 2.19 ml min-1 1.73 m-2 (95% CI 1.00, 3.38; P < 0.001) in patients with baseline eGFR <60 ml min-1 1.73 m-2. These results suggest a benefit of semaglutide on kidney outcomes in individuals with overweight/obesity, without diabetes.ClinicalTrials.gov identifier: NCT03574597 .
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Sep 13, 2026 | 38796653 first ingestion |