{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T11:32:47Z","timestamp":1785929567615,"version":"3.56.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) that has demonstrated metabolic and weight benefits in diabetic and obese patients with chronic kidney disease (CKD) who are not on dialysis; however, evidence in the hemodialysis (HD) population is scarce. Weight control and body composition optimization are particularly challenging in HD because of fluid shifts and the risk of protein-energy wasting. Materials and Methods: This prospective, multicenter, real-world, uncontrolled observational pilot study explored the short-term safety and changes in anthropometric and body-composition parameters after semaglutide initiation in obese adults with type 2 diabetes mellitus (T2DM) undergoing chronic HD. Patients were assessed at baseline and at 3 and 6 months. The primary endpoint was the change in body mass index (BMI), dry weight, and fat mass assessed by bioimpedance spectroscopy (BIS). Results: Thirteen patients were included (10 male, 77%), with a median age of 61.9 years (IQR 55\u201369). Semaglutide was started at 0.25 mg\/week and titrated up to 1 mg\/week according to tolerance. Three patients (23.1%) experienced transient nausea that was resolved over time or after dose adjustment, without discontinuation. From baseline to month +6, BMI decreased by a median of 1.5 kg\/m2 and dry weight by 5.0 kg, mainly driven by a median reduction in fat mass of 9 kg; lean tissue mass and serum albumin did not change significantly. Conclusions: In this small, uncontrolled exploratory study, semaglutide was generally well tolerated and was associated with short-term reductions in body weight and fat mass in obese patients with T2DM on HD. These findings are hypothesis-generating and require confirmation in larger controlled prospective studies to define safety and clinical benefit in this population.<\/jats:p>","DOI":"10.3390\/medicina62020386","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T12:37:28Z","timestamp":1771245448000},"page":"386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Preliminary Real-World Experience with Semaglutide in Obese Patients with Type 2 Diabetes on Chronic Hemodialysis: A Multicenter Pilot Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8020-7276","authenticated-orcid":false,"given":"Alejandra","family":"Yugueros","sequence":"first","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital Lluis Alcanyis de Xativa, 46800 Valencia, Spain"},{"name":"Grupo de Investigaci\u00f3n en Enfermedades Cardiorrenales y Metab\u00f3licas, Departamento de Medicina y Cirug\u00eda, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0148-891X","authenticated-orcid":false,"given":"Luis","family":"D\u2019Marco","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Enfermedades Cardiorrenales y Metab\u00f3licas, Departamento de Medicina y Cirug\u00eda, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Valero","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda, Hospital Doctor Peset, 46017 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Viv\u00f3","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda, Hospital de la Ribera, 46600 Alzira, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Mart\u00ednez-Mas","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital Lluis Alcanyis de Xativa, 46800 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Calv\u00e9","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital Lluis Alcanyis de Xativa, 46800 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Alonso","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital Lluis Alcanyis de Xativa, 46800 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Vizca\u00edno","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda, Hospital Doctor Peset, 46017 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Gonz\u00e1lez-Moya","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda, Hospital Doctor Peset, 46017 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8958-6711","authenticated-orcid":false,"given":"Ana","family":"Checa-Ros","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Enfermedades Cardiorrenales y Metab\u00f3licas, Departamento de Medicina y Cirug\u00eda, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asunci\u00f3n","family":"Sancho","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda, Hospital Doctor Peset, 46017 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8311-6214","authenticated-orcid":false,"given":"Pablo","family":"Molina","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"},{"name":"Departament de Medicina, Facultat de Medicina i Odontlogia, Universitat de Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref_1","first-page":"34","article-title":"Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal cr\u00f3nica","volume":"34","author":"Artola","year":"2014","journal-title":"Nefrologia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2020.06.019","article-title":"KDIGO 2020 Clinical Practice Guideline for Diabetes Management in 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