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Semaglutide-associated kidney injury.

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Clinical Kidney Journal
|September 11, 2024
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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) can cause kidney adverse events, including acute interstitial nephritis (AIN). This study highlights semaglutide-associated AIN and podocytopathy, emphasizing the need for prescriber awareness.

Keywords:
AINAKIGLP1 agonistacute interstitial nephritisdiffuse podocytopathyminimal change diseasepodocytopathysemaglutide

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Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacovigilance

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for type 2 diabetes, obesity, and cardiovascular risk reduction.
  • Increased GLP-1RA utilization has coincided with reports of kidney adverse events.
  • Acute interstitial nephritis (AIN) is a notable kidney adverse event associated with GLP-1RA therapy.

Observation:

  • Analysis of the FDA Adverse Event Reporting System (FAERS) identified acute kidney injury as the most common adverse kidney event linked to GLP-1RAs.
  • Two cases of semaglutide-associated biopsy-proven AIN and one case of associated podocytopathy were reported.
  • FAERS data also indicated 17 cases of proteinuria and 1 case of glomerulonephritis associated with semaglutide.

Findings:

  • This case series presents the first biopsy-proven association of semaglutide with AIN and podocytopathy.
  • Patients with semaglutide-associated AIN and podocytopathy achieved complete remission after drug discontinuation and immunosuppressive therapy.
  • The findings suggest a potential link between semaglutide and specific kidney pathologies.

Implications:

  • While GLP-1RAs offer significant benefits, prescribers must be aware of potential rare kidney adverse events like AIN and podocytopathy.
  • Further research is warranted to establish causality between semaglutide and these renal adverse events.
  • Increased vigilance and reporting are crucial as the use of GLP-1RAs continues to expand in clinical practice.