Semaglutide-associated kidney injury.

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.