A systematic review of semaglutide-associated kidney injury case reports.

Xiu X, Zheng PP, Li Y, Du M, Min X, Pang X, Zhang L, Liu J, Zhao Z, Liu ZC, Feng CX

Frontiers in medicine1 Jun 2026

PMID42305970PMCIDPMC13265316DOI10.3389/fmed.2026.1793349PepBankPUB-42305970

Summary

BackgroundAlthough semaglutide is widely used due to its efficacy in glycemic control and weight reduction, cases of the associated adverse drug reactions (ADRs), including kidney injury, have gradually increased. This systematic review aimed to summarize reported cases and case series of semaglutide-associated renal injury and their clinical and laboratory features.MethodsCase reports and case series on ADRs associated with semaglutide published in English and Chinese were systematically retrieved using relevant keywords from PubMed/MEDLINE, Web of Science, Embase, the Cochrane Library, and the Chinese National Knowledge Infrastructure (CNKI) database from database inception to October 31, 2025. Demographic characteristics, clinical information, ADRs, kidney-related laboratory tests, and outcomes were extracted. We used the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports (JBI Case Report Checklist) to evaluate the quality of each included study.ResultsA total of 20 cases (7 males and 13 females) from 18 studies were included after screening 1039 selected publications, with patient ages ranging from 29 to 83 years. Most patients received semaglutide via subcutaneous injection for weight loss or blood sugar reduction. Except for one case with unknown history, all patients had a pre-existing medical condition and were receiving concomitant medications. ADRs occurred at the standard recommended dose, ranging from 0.25 to 2.0 mg and included acute kidney injury (AKI), acute renal failure (ARF), and acute interstitial nephritis (AIN). Twelve cases were diagnosed through renal biopsy, and the remaining eight cases were diagnosed based on renal function parameters. The dosage varied from 0.25 to 2.0 mg per week. The majority of patients developed ADRs after multiple administrations. The clinical manifestations of the patients were diverse. Following treatment, 17 patients improved or recovered, outcomes were not reported in two patients, and one patient did not recover.ConclusionSemaglutide use may be associated with kidney damage, which may be irreversible. Clinicians should be cautious when prescribing semaglutide to individuals with underlying conditions and those receiving concomitant medications, and should ensure regular monitoring of kidney function after treatment initiation.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study4

4 results from studies that gave the peptide. 4 results from people.

01HumanSystematic reviewSafety outcome
In 20 reported cases, semaglutide at standard doses of 0.25 to 2.0 mg was associated with acute kidney injury, acute renal failure and acute interstitial nephritis.
In plain wordsIn 20 reported cases, people on semaglutide at usual doses had kidney injury. Case reports cannot show that semaglutide caused it.
Peptide
Semaglutide
Outcome
IncreaseKidney injury adverse drug reactions
Study
n = 20
Outcome group
Adverse events · Kidney and urinary
Studied dose
0.25 to 2.0 mg per week · subcutaneous injection (most patients)As given in this study (human).
Measurements
Cases
20 cases
included reports
Source sentences
Summary
ADRs occurred at the standard recommended dose, ranging from 0.25 to 2.0 mg and included acute kidney injury (AKI), acute renal failure (ARF), and acute interstitial nephritis (AIN).
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 20 cases (7 males and 13 females) from 18 studies were included after screening 1039 selected publications, with patient ages ranging from 29 to 83 years.
Show in the study text Report a problemFND-4230597001
02HumanSystematic reviewOther
Twelve of the 20 cases were diagnosed through renal biopsy and eight based on renal function parameters.
In plain wordsTwelve of the 20 kidney injury cases were confirmed by kidney biopsy and eight by kidney function tests.
Peptide
Semaglutide
Outcome
Not applicableDiagnostic basis of kidney injury
Study
n = 20
Outcome group
Adverse events · Kidney and urinary
Studied dose
0.25 to 2.0 mg per week · subcutaneous injection (most patients)As given in this study (human).
Measurements
Biopsy-diagnosed cases
12 cases
renal biopsy
Function-diagnosed cases
8 cases
renal function parameters
Source sentences
Summary
Twelve cases were diagnosed through renal biopsy, and the remaining eight cases were diagnosed based on renal function parameters.
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 20 cases (7 males and 13 females) from 18 studies were included after screening 1039 selected publications, with patient ages ranging from 29 to 83 years.
Show in the study text Report a problemFND-4230597002
03HumanSystematic reviewOther
The majority of patients developed kidney adverse drug reactions after multiple administrations of semaglutide.
In plain wordsMost of these patients developed kidney problems after several doses of semaglutide, not after the first.
Peptide
Semaglutide
Outcome
Not applicableTiming of kidney injury relative to dosing
Study
n = 20
Outcome group
Adverse events · Kidney and urinary
Studied dose
0.25 to 2.0 mg per week · subcutaneous injection (most patients)As given in this study (human).
Source sentences
Summary
The majority of patients developed ADRs after multiple administrations.
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 20 cases (7 males and 13 females) from 18 studies were included after screening 1039 selected publications, with patient ages ranging from 29 to 83 years.
Show in the study text Report a problemFND-4230597003
04HumanSystematic reviewSafety outcome
After treatment, 17 of 20 patients improved or recovered, outcomes were not reported in two, and one patient did not recover.
In plain wordsAfter treatment, 17 of the 20 patients improved or recovered, two had no outcome reported, and one did not recover.
Peptide
Semaglutide
Outcome
Not applicableOutcome of kidney injury after treatment
Study
n = 20
Outcome group
Adverse events · Kidney and urinary
Studied dose
0.25 to 2.0 mg per week · subcutaneous injection (most patients)As given in this study (human).
Measurements
Improved or recovered
17 patients
after treatment
Not recovered
1 patients
after treatment
Source sentences
Summary
Following treatment, 17 patients improved or recovered, outcomes were not reported in two patients, and one patient did not recover.
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 20 cases (7 males and 13 females) from 18 studies were included after screening 1039 selected publications, with patient ages ranging from 29 to 83 years.
Show in the study text Report a problemFND-4230597004

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Version history

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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

Keywords

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