Mechanistic Kidney Effects of Semaglutide by Baseline SGLT2i Use in Type 2 Diabetes: A Post-hoc Analysis of the REMODEL Trial

 

Certificate Output Instructions

For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".

To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".

 


 

Certificate Background

   

Presented the abstract " "
(Abstract co-author(s):  )

 

 

E-Poster Presentation

During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center. 

Preparing your E-Poster

Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.

​E-Poster Submission Deadline

Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.​

E-Poster Format Requirements
  • PDF file
  • Layout: Portrait (vertical orientation)
  • One page only (Dim A4: 210 x 297mm or PPT)
  • E-Poster can be prepared in PowerPoint (one (1) PowerPoint slide) but must be saved and submitted as PDF file.
  • File Size: Maximum file size is 2 Megabytes (2 MB)
  • No hyperlinks, animated images, animations, and slide transitions
  • Language: English
  • Include your abstract number
  • E-posters can include QR codes, tables and photos
 
Mechanistic Kidney Effects of Semaglutide by Baseline SGLT2i Use in Type 2 Diabetes: A Post-hoc Analysis of the REMODEL Trial

Please follow the instructions below to input your abstract title.

Abstract titles should be brief and reflect the content of the abstract.

  • The title will not be accepted if it exceeds 25 words.
  • Type in CAPITAL LETTERS.
  • Lowercase may be used for abbreviations only, for example, mRNA.
David
Cherney
David Cherney David.Cherney@uhn.ca University Health Network Division of Nephrology, Department of Medicine Toronto Canada *
Radica Alicic Radica.Alicic@providence.org Providence Medical Research Center Providence Inland Northwest Health Spokane United States -
Milenta Chacko RZCH@novonordisk.com Novo Nordisk GBS India Biostatistics Bangalore India -
Lynette Driscoll lynette.driscoll@cuanschutz.edu University of Colorado Anschutz Medical Campus Pediatric Endocrinology Aurora United States -
Emma Olesen ETBO@novonordisk.com Novo Nordisk A/S Medical & Science Søborg Denmark -
Prachi Priyadarshini PCPH@novonordisk.com Novo Nordisk GBS India Global Medical Affairs Bangalore India -
Vikas Sridhar vikassrinivasan.sridhar@uhn.ca University of British Columbia Division of Nephrology, Department of Medicine Vancouver Canada -
Katherine Tuttle Katherine.Tuttle@providence.org Providence Medical Research Center Providence Inland Northwest Health Spokane United States - University of Washington School of Medicine Kidney Research Institute and Nephrology Division Seattle United States
Petter Bjornstad pettermb@uw.edu University of Washington Medicine Diabetes Institute Division of Metabolism, Endocrinology and Nutrition, Department of Medicine Seattle United States - University of Washington Division of Endocrinology, Department of Pediatrics Seattle United States University of Colorado Anschutz Medical Campus Division of Renal Diseases and Hypertension, Department of Medicine, and Department of Pediatrics, Section of Endocrinology Aurora United States
 
 
 
 
 
 

Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), confers kidney protection in people with type 2 diabetes (T2D) and chronic kidney disease (CKD) by improving kidney hemodynamics and stabilizing fibrosis. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) represent a distinct drug class with established nephroprotective effects, mediated by hemodynamic mechanisms including reductions in glomerular hyperfiltration. Although both drug classes lower blood glucose levels, emerging evidence suggests that their kidney-protective mechanisms are largely independent and potentially additive. We hypothesized that semaglutide exerts kidney hemodynamic effects irrespective of background SGLT2i therapy. Therefore, we evaluated some kidney-protective effects of semaglutide 1.0 mg stratified by SGLT2i use.

The study is a post-hoc analysis of the REMODEL trial (NCT04865770). Adults with T2D, estimated glomerular filtration rate (eGFR) of 30-75 mL/min/1.73 m2, and urine albumin-creatinine ratio (UACR) 20-<5000 mg/g were randomized 2:1 to once-weekly semaglutide subcutaneous 1.0 mg (n=71) or placebo (n=35) for 52 weeks and stratified by concomitant treatment with SGLT2i. Kidney oxygenation (R2*) was assessed by blood oxygenation level dependent magnetic resonance imaging (BOLD-MRI), while mean global kidney perfusion (GKP), renal artery resistive index (RARI), and cortical and medullary estimates of fibrosis (diffusion weighted imaging for the apparent diffusion coefficient [ADC]) were assessed by phase-contrast MRI measured arterial flow. 

At baseline, SGLT2i users and non-users exhibited similar eGFR-creatinine, though UACR was higher among SGLT2i users (Table 1). The effect of semaglutide to reduce RARI was observed in both SGLT2i users and non-users (p-interaction [p-int]=0.29). SGLT2i use did not impact the increase in cortical ADC or delta ADC observed with semaglutide vs placebo, reflecting stabilized fibrosis or lack of progression in both groups (p-int=0.73 and p-int=0.53, respectively). The ratio of cortical R2* and medullary R2* from baseline to week 52 in semaglutide and placebo groups did not differ significantly between SGLT2i users vs non-users (p-int=0.88 and p-int=0.84, respectively). There was a trend toward a higher GKP in the semaglutide group vs placebo, with similar effects in SGLT2i users and non-SGLT2i users (p-int=0.42).

In REMODEL, semaglutide had similar effects to reduce RARI and mitigate fibrosis irrespective of background SGLT2i therapy. The combination of semaglutide treatment with SGLT2i use may confer additional kidney benefits.

Kewords