Effects of Semaglutide With or Without Concomitant Mineralocorticoid Receptor Antagonist Use in Participants With Type 2 Diabetes and Chronic Kidney Disease: A FLOW Trial Prespecified Secondary Analysis.

Rossing P, Bakris G, Perkovic V, Pratley R, Tuttle KR, Mahaffey KW, Idorn T, Belmar N, Bosch-Traberg H, Rasmussen S, Busch RS, Schmieder RE, Gillard P, Mann JFE

Diabetes care1 Nov 2025Cited by 19 (Europe PMC)

PMID40730031PMCIDPMC12583412DOI10.2337/dc25-0472PepBankPUB-40730031

Source link PubMedAsk about this study

Jump to 8 results

Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study8

8 results from studies that gave the peptide. 8 results from people.

01HumanRandomized controlled trialEfficacy outcome
In adults with type 2 diabetes and chronic kidney disease who did not use a mineralocorticoid receptor antagonist, semaglutide reduced the risk of the primary kidney outcome by 21% versus placebo.
In plain wordsIn adults with type 2 diabetes and kidney disease not taking an MRA drug, semaglutide lowered major kidney outcome risk more than placebo.
Peptide
Semaglutide
Outcome
DecreasePrimary kidney outcome in MRA non-users
Study
n = 3,276
Comparator
Placebo
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Studied dose
1.0 mg · subcutaneousAs given in this study (human).
Measurements
Hazard ratio
0.79
MRA non-users
Source sentences
Summary
Semaglutide reduced the risk of the primary kidney outcome by 49% (59 events; hazard ratio [HR] 0.51 [95% CI 0.30, 0.86]) and 21% (682 events; HR 0.79 [95% CI 0.68, 0.92]; P-interaction = 0.12) versus placebo in MRA and non-MRA subgroups, respectively.
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003102
02HumanRandomized controlled trialEfficacy outcome
In adults with type 2 diabetes and chronic kidney disease who used a mineralocorticoid receptor antagonist, semaglutide reduced the risk of the primary kidney outcome by 49% versus placebo.
In plain wordsIn adults with type 2 diabetes and kidney disease who took an MRA drug, semaglutide lowered the risk of major kidney outcomes more than placebo.
Peptide
Semaglutide
Outcome
DecreasePrimary kidney outcome in MRA users
Study
n = 257
Comparator
Placebo
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Studied dose
1.0 mg · subcutaneousAs given in this study (human).
Measurements
Hazard ratio
0.51
MRA users
Source sentences
Summary
Semaglutide reduced the risk of the primary kidney outcome by 49% (59 events; hazard ratio [HR] 0.51 [95% CI 0.30, 0.86]) and 21% (682 events; HR 0.79 [95% CI 0.68, 0.92]; P-interaction = 0.12) versus placebo in MRA and non-MRA subgroups, respectively.
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003101
03HumanRandomized controlled trialEfficacy outcome
In non-users of MRA with type 2 diabetes and chronic kidney disease, albuminuria at 104 weeks fell by 33% from baseline with semaglutide versus placebo.
In plain wordsIn people with type 2 diabetes and kidney disease who did not take an MRA drug, semaglutide lowered albuminuria more than placebo.
Peptide
Semaglutide
Outcome
DecreaseAlbuminuria at 104 weeks in MRA non-users
Study
n = 3,276
Comparator
Placebo
Outcome group
Kidney function · Kidney and urinary
Studied dose
1.0 mg · subcutaneous · 104 weeksAs given in this study (human).
Measurements
Albuminuria change
−33%
MRA non-users, week 104
Source sentences
Summary
Albuminuria at 104 weeks was reduced from baseline with semaglutide by 15% (95% CI -41, 31) in MRA users and 33% (26, 39) in nonusers versus placebo (P-interaction = 0.22).
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003106
04HumanRandomized controlled trialEfficacy outcome
In MRA users with type 2 diabetes and chronic kidney disease, albuminuria at 104 weeks fell by 15% from baseline with semaglutide versus placebo, with a confidence interval from -41 to 31.
In plain wordsIn MRA users with type 2 diabetes and kidney disease, the 15% albuminuria reduction with semaglutide versus placebo was uncertain, with a wide range.
Peptide
Semaglutide
Outcome
No significant changeAlbuminuria at 104 weeks in MRA users
Study
n = 257
Comparator
Placebo
Outcome group
Kidney function · Kidney and urinary
Studied dose
1.0 mg · subcutaneous · 104 weeksAs given in this study (human).
Measurements
Albuminuria change
−15%
MRA users, week 104
Source sentences
Summary
Albuminuria at 104 weeks was reduced from baseline with semaglutide by 15% (95% CI -41, 31) in MRA users and 33% (26, 39) in nonusers versus placebo (P-interaction = 0.22).
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003105
05HumanRandomized controlled trialEfficacy outcome
In adults with type 2 diabetes and chronic kidney disease, the effect of semaglutide on major adverse cardiovascular events favored semaglutide in both MRA users and non-users, with no heterogeneity between subgroups (P-interaction > 0.7).
In plain wordsIn adults with type 2 diabetes and kidney disease, semaglutide's effect on major heart and vessel events was similar with or without an MRA drug.
Peptide
Semaglutide
Outcome
DecreaseMACE effect by baseline MRA use
Study
n: not reported in source
Comparator
Placebo
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
1.0 mg · subcutaneousAs given in this study (human).
Source sentences
Summary
There was no heterogeneity, favoring the effects of semaglutide on major adverse CV events (MACE) and all-cause mortality in both MRA subgroups (P-interaction > 0.7).
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003103
06HumanRandomized controlled trialEfficacy outcome
In adults with type 2 diabetes and chronic kidney disease, the effect of semaglutide on all-cause mortality favored semaglutide in both MRA users and non-users, with no heterogeneity between subgroups (P-interaction > 0.7).
In plain wordsIn adults with type 2 diabetes and kidney disease, semaglutide's effect on death from any cause was similar with or without an MRA drug.
Peptide
Semaglutide
Outcome
DecreaseAll-cause mortality effect by baseline MRA use
Study
n: not reported in source
Comparator
Placebo
Outcome group
Mortality · Whole body
Studied dose
1.0 mg · subcutaneousAs given in this study (human).
Source sentences
Summary
There was no heterogeneity, favoring the effects of semaglutide on major adverse CV events (MACE) and all-cause mortality in both MRA subgroups (P-interaction > 0.7).
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003104
07HumanRandomized controlled trialEfficacy outcome
In adults with type 2 diabetes and chronic kidney disease, semaglutide similarly reduced the decline in estimated glomerular filtration rate in MRA users and non-users.
In plain wordsIn adults with type 2 diabetes and kidney disease, semaglutide slowed kidney function decline to a similar degree with or without an MRA drug.
Peptide
Semaglutide
Outcome
DecreaseeGFR decline by baseline MRA use
Study
n: not reported in source
Comparator
Placebo
Outcome group
Kidney function · Kidney and urinary
Studied dose
1.0 mg · subcutaneousAs given in this study (human).
Source sentences
Summary
Estimated glomerular filtration rate decline was similarly reduced with semaglutide (P-interaction = 0.71).
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003107
08HumanRandomized controlled trialSafety outcome
In adults with type 2 diabetes and chronic kidney disease, the safety profile of semaglutide was comparable between MRA users and non-users.
In plain wordsIn adults with type 2 diabetes and kidney disease, semaglutide's safety was similar in people who did and did not take an MRA drug.
Peptide
Semaglutide
Outcome
No significant changeSafety profile by baseline MRA use
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
1.0 mg · subcutaneousAs given in this study (human).
Source sentences
Summary
The safety profile of semaglutide was comparable between subgroups.
2 context sentences(design, population, supporting numbers)
Summary · context
Participants were randomized to once-weekly subcutaneous semaglutide 1.0 mg or placebo.
Summary · context
Effects were analyzed by baseline MRA use (n = 257 [136 in the semaglutide group and 121 in the placebo group]) and nonuse (n = 3,276 [1,631 in the semaglutide group and 1,645 in the placebo group]).
Report a problemFND-4073003108

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

Publication types

MeSH terms

PepBank is a research reference. Talk to a doctor before you use any peptide.