{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T05:51:16Z","timestamp":1791697876711,"version":"4.3.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","funder":[{"name":"Novo Nordisk","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Treatment with semaglutide compared with placebo for 24 weeks reduced lean body mass and fat mass in adults with CKD and overweight or obesity.<\/jats:p>\n <\/jats:list-item>\n \n Changes in lean body mass or fat mass during semaglutide treatment did not correlate with changes in creatinine or cystatin C\u2011eGFR or measured GFR.<\/jats:p>\n <\/jats:list-item>\n \n Semaglutide significantly reduced extracellular water and BP, and changes in BP correlated with extracellular water.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n The glucagon-like peptide-1 receptor agonist semaglutide reduces hemoglobin A1c, body weight, BP, and GFR decline. Semaglutide may influence serum creatinine and cystatin C levels by nonkidney-related mechanisms and thereby affect eGFR. We studied the relationship between changes in body composition, eGFR and measured GFR (mGFR), and BP during semaglutide treatment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a prespecified analysis of a randomized placebo-controlled double-blind clinical trial in 101 adults with CKD with overweight status or obesity and without type 2 diabetes. Participants were randomized to 24 weeks of semaglutide 2.4 mg\/wk subcutaneously or matched placebo treatment. We measured GFR with iohexol clearance, estimated GFR with creatinine and cystatin C, and used bioimpedance spectroscopy to determine lean body mass, fat mass, and extracellular water.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After 24 weeks of treatment, semaglutide compared with placebo changed total body weight, lean body mass, and fat mass by \u22129.1 (95% confidence interval [CI], \u221211.0 to \u22127.2), \u22122.5 (95% CI, \u22126.6 to 1.6), and \u22123.9 (95% CI, \u22127.8 to 0.0) kg, respectively. No correlations were present between changes in total body weight, lean body mass, and fat mass with changes in eGFR (creatinine or cystatin C) or mGFR during semaglutide treatment (all Spearman correlation coefficients <0.23). Similar results were observed in multivariable adjusted analyses. Semaglutide compared with placebo changed extracellular water and systolic BP by \u22120.9 (95% CI, \u22121.6 to \u22120.1) L and \u22126.3 (95% CI, \u221210.9 to \u22121.7) mm Hg, respectively. Systolic BP changes during semaglutide treatment correlated with extracellular water changes (Spearman correlation 0.40;\n P<\/jats:italic>\n = 0.005).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Semaglutide reduced lean body mass and fat mass in patients with CKD with overweight status or obesity. These changes did not correlate with changes in creatinine or cystatin C eGFR or mGFR, suggesting that body weight reductions of 10% with semaglutide do not influence GFR estimates.<\/jats:p>\n <\/jats:sec>\n \n Clinical Trial registry name and registration number:<\/jats:title>\n ClinicalTrials.gov, NCT04889183.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000001051","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T16:00:39Z","timestamp":1777564839000},"page":"1149-1158","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Semaglutide on Body Composition and GFR"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-3730","authenticated-orcid":false,"given":"Hiddo J.L.","family":"Heerspink","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"},{"name":"The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3621-0766","authenticated-orcid":false,"given":"Maria","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Institute of Research, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4615-9012","authenticated-orcid":false,"given":"Jelle M.","family":"Beernink","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0882-3656","authenticated-orcid":false,"given":"Niels","family":"Jongs","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9043-992X","authenticated-orcid":false,"given":"Secundino","family":"Cigarran","sequence":"additional","affiliation":[{"name":"Nephrology Service Hospital Ribera-Polusa Lugo, Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-8558","authenticated-orcid":false,"given":"Josep M.","family":"Cruzado","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari Bellvitge, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jes\u00fas","family":"Puchades","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Clinical Hospital, INCLIVA, University of Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4284-831X","authenticated-orcid":false,"given":"Marina","family":"L\u00f3pez-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Institute of Research, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0271-5796","authenticated-orcid":false,"given":"Ellen","family":"Apperloo","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4417-7732","authenticated-orcid":false,"given":"Femke","family":"Waanders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Isala Zwolle, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8716-7115","authenticated-orcid":false,"given":"Gozewijn D.","family":"Laverman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, ZiekenhuisGroep Twente, Almelo, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1473-3259","authenticated-orcid":false,"given":"Annemarie","family":"van der Aart-van der Beek","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy, Martini Hospital, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0335-8177","authenticated-orcid":false,"given":"Andr\u00e9 P.","family":"van Beek","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobien C.","family":"Verhave","sequence":"additional","affiliation":[{"name":"Department Internal Medicine, Rijnstate Ziekenhuis, Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3000-2229","authenticated-orcid":false,"given":"Sofia B.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada"},{"name":"Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2356-5883","authenticated-orcid":false,"given":"Roland E.","family":"Schmieder","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, University Hospital Erlangen Friedrich-Alexander University Erlangen-N\u00fcrnberg (FAU), Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-5301","authenticated-orcid":false,"given":"Christoph","family":"Wanner","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies and Epidemiology. Comprehensive Heart Failure Center University Hospital W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Z.I.","family":"Cherney","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-9051","authenticated-orcid":false,"given":"Jos\u00e9 L.","family":"G\u00f3rriz","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Clinical Hospital, INCLIVA, University of Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"2","key":"B1-20260723","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1093\/ndt\/gfae150","article-title":"Effect of semaglutide on kidney function across different 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