{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:03:42Z","timestamp":1790762622434,"version":"4.1.0"},"reference-count":84,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic kidney disease (CKD) and cardiovascular disease (CVD) are major causes of morbidity and mortality in people with type 2 diabetes (T2D). Contemporary CKD guidelines increasingly support incorporation of glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) as an additional pillar of cardiorenal therapy alongside renin\u2013angiotensin\u2013aldosterone system (RAAS) blockade, sodium\u2013glucose co\u2010transporter 2 inhibitors (SGLT2i) and finerenone. Semaglutide is the first GLP\u20101RA with kidney\u2010outcome data from a dedicated trial in T2D\u2010CKD: the Evaluate Renal Function with Semaglutide Once Weekly (FLOW) study. In FLOW, once\u2010weekly subcutaneous semaglutide 1 mg reduced major kidney disease events by 24%, major adverse cardiovascular events by 18% and all\u2010cause mortality by 20% versus placebo on a background of guideline\u2010directed therapy. Here a multidisciplinary expert panel summarises Australian Therapeutic Goods Administration indications and Pharmaceutical Benefits Scheme restrictions, highlights common access barriers and outlines approaches to shared care between primary and tertiary services for use of GLP\u20101RAs. Guidance is also provided on treatment sequencing of GLP\u20101RA alongside RAAS blockade, SGLT2i and finerenone. Evidence from key GLP\u20101RA trials, in addition to FLOW, is reviewed and translated into practical, implementable prescribing strategies for Australian clinicians. The panel also identified priority patient groups for GLP\u20101RA therapy, including those with residual albuminuria, heart failure with preserved ejection fraction, established CVD, obesity and Aboriginal and Torres Strait Islander peoples at high cardiorenal risk. Remaining evidence gaps, particularly for non\u2010diabetic CKD, advanced CKD, dialysis and transplant populations and equity of access, are identified as priorities for future research and policy.<\/jats:p>","DOI":"10.1111\/imj.70647","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:27:58Z","timestamp":1790760478000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Semaglutide in type 2 diabetes and chronic kidney disease in Australia: practical clinical considerations from a multidisciplinary panel"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9019-8646","authenticated-orcid":false,"given":"Eugenia","family":"Pedagogos","sequence":"first","affiliation":[{"name":"Western Health  Melbourne Victoria Australia"},{"name":"University of Melbourne  Melbourne Victoria Australia"},{"name":"Epworth Freemasons  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St Vincent's Hospital Sydney  Sydney New South Wales Australia"},{"name":"Victor Chang Cardiac Research Institute  Sydney New South Wales Australia"},{"name":"Department of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0990-2548","authenticated-orcid":false,"given":"Adam","family":"Nelson","sequence":"additional","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2269-312X","authenticated-orcid":false,"given":"Sunil","family":"Badve","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Renal Medicine St George Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Rasalam","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes Alfred Health  Melbourne Victoria Australia"},{"name":"Faculty of Medicine University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8058-6977","authenticated-orcid":false,"given":"Richard","family":"MacIsaac","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes St Vincent's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Department of Medicine, St Vincent's Hospital Melbourne University of Melbourne  Melbourne Victoria Australia"},{"name":"The Australian Centre for Accelerating Diabetes Innovations University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney Int"},{"key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"S246","DOI":"10.2337\/dc26-S011","article-title":"11. 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