Evidence map›Paper›PMID 42823485›Full record

ArticleNature medicine2026

Effects of semaglutide on kidney disease in type 2 diabetes: a randomized placebo-controlled trial.

Katherine R Tuttle, Petter Bjornstad, Cathy Smith, Menno Pruijm, Phillip J McCown, Jeffrey B Hodgin, David Z I Cherney, Nicolas Belmar, Milenta Mariam Chacko, Vivek Das and 5 more

Registry-linked trialAbstract read
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In one paragraph

Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT04865770. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04865770 phase3completed

Renal Mode of Action of Semaglutide in Patients With Type 2 Diabetes and Chronic Kidney Disease

Ran2021Enrolled106Registered outcomes14Posted comparisons15ConditionsChronic Kidney Disease, Diabetes Mellitus, Type 2ArmsPlacebo (semaglutide), semaglutide
Open the trial in the graph
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Katherine R Tuttle *Providence, Medical Research Center, Providence Inland Northwest Health, Spokane, WA, US. katherine.tuttle@providence.org.ORCID http://orcid.org/0000-0002-2235-0103
Petter Bjornstad *Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington Medicine Diabetes Institute, and Division of Endocrinology, Department of Pediatrics, University of Washington, Seattle, WA, US. pettermb@uw.edu.ORCID http://orcid.org/0000-0002-5160-2947
Cathy SmithDepartment of Internal Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, US.ORCID http://orcid.org/0000-0003-1518-9320
Menno PruijmService of Nephrology, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0000-0003-1027-1851
Phillip J McCownDepartment of Internal Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, US.ORCID http://orcid.org/0000-0002-8012-1931
Jeffrey B HodginDepartment of Pathology and Clinical Laboratories, University of Michigan, Ann Arbor, MI, US.
David Z I CherneyDepartment of Medicine, Nephrology Division, University Health Network, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-4164-0429
Nicolas BelmarNovo Nordisk A/S, Søborg, Denmark.
Milenta Mariam ChackoNovo Nordisk GBS India, Bangalore, India.ORCID http://orcid.org/0009-0006-1465-2095
Vivek DasNovo Nordisk A/S, Søborg, Denmark.ORCID http://orcid.org/0000-0003-0614-0373
Thomas P GunnarssonNovo Nordisk A/S, Søborg, Denmark.
Thomas IdornNovo Nordisk A/S, Søborg, Denmark.ORCID http://orcid.org/0009-0009-4896-5868
Philip A SchytzNovo Nordisk A/S, Søborg, Denmark.
Amaya ZaratieguiNovo Nordisk A/S, Søborg, Denmark.ORCID http://orcid.org/0009-0007-6522-2703
Matthias KretzlerDepartment of Internal Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, US. kretzler@umich.edu.ORCID http://orcid.org/0000-0003-4064-0582

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The GLP-1 receptor agonist semaglutide preserves kidney function in people with type 2 diabetes and chronic kidney disease, but the underlying mechanisms are unclear. Here we report a 52-week randomized trial of subcutaneous semaglutide 1 mg once weekly versus placebo (n = 106 (n = 25 women, n = 81 men)) in participants with type 2 diabetes and chronic kidney disease. To identify kidney-specific mechanisms of action for semaglutide, we performed integrated multiparametric magnetic resonance imaging of the kidney and biopsy for histology (n = 33), alongside single-nucleus (n = 22) and spatial transcriptomics (n = 13) on paired samples with before- and after-treatment measurements. Coprimary magnetic resonance imaging outcomes (oxygenation by R2*, global perfusion and tissue inflammation by T1 mapping) were not significantly altered by semaglutide versus placebo treatment. Secondary outcomes revealed that semaglutide treatment, as compared to placebo, was associated with a significantly reduced renal artery resistive index and stabilization of the apparent diffusion coefficient, indicating prevention of fibrosis progression. Moreover, secondary transcriptomic outcomes revealed pronounced effects of semaglutide on glomerular endothelial cells, consistent with the results of spatial analyses indicating reduced numbers of immune cells in the proximity of these endothelial cells. The results from this trial indicate that mechanisms of kidney protection by semaglutide may include reduced vascular resistance, prevention of fibrosis and improved underlying molecular programs promoting endothelial cell health. ClinicalTrials.gov identifier: NCT04865770 .

Identifiers

PMID42823485

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.