Effect of semaglutide on kidney outcomes in the SELECT, FLOW, and SOUL trials: a prespecified pooled analysis
Pooled result · Primary kidney composite, first eventsResult — go to the resultHazard ratio 0.84 95% CI 0.77–0.91Authors' conclusion
Data pooled from three large phase 3 trials suggest that semaglutide reduces the risk of major kidney outcomes in a broad population with cardio-kidney-metabolic disease while having a favourable risk-benefit profile.
Study context
- Population
- Participants with chronic kidney disease (CKD) (FLOW) or atherosclerotic CVD (SELECT and SOUL)
- Participants
- 30,787 participants3 RCTs
- Comparison
- Semaglutide vs placebo, added to standard of care
- Outcome
- Time to first kidney composite:
- Persistent ≥50% estimated glomerular filtration rate (eGFR) reduction
- Kidney failure (persistent eGFR <15 mL/min per 1.73 m², or kidney replacement therapy)
- Kidney-related death
- Cardiovascular-related death
- Follow-up
- Mean 39.5-47.5 months
Methodological detailsphase 3 trials
- Phase 3 trials
Pooled result
Primary kidney composite, first events
Hazard ratio
0.84
95% CI 0.77–0.91
Events by group
Semaglutide
973
events
Placebo
1134
events
Semaglutidevs Placebo
HR 0.84 (95% CI 0.77–0.91)
As reported in the abstract
Further pooled results
Events
| Outcome | Semaglutide | Placebo | Estimate |
|---|---|---|---|
| Narrower secondary kidney composite (excluding cardiovascular-related death), first events | 347 | 416 | 0.80 (CI 0.69–0.92) |
Safety
- Safety outcomes overall similar between groups, in line with other GLP-1 RA trials
- Serious adverse events numerically lower with semaglutide than placebo
Original publication
Effect of semaglutide on kidney outcomes in the SELECT, FLOW, and SOUL trials: a prespecified pooled analysis. Lancet Diabetes Endocrinol. Published 7 August 2026. doi:10.
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