Early cardiovascular outcome trials of GLP-1RAs for diabetes included secondary kidney endpoints, typically defined by a 5-point composite renal outcome (CRO): increased urinary albumin-to-creatinine ratio, new-onset macroalbuminuria, sustained decline in estimated glomerular filtration rate (eGFR), initiation of chronic renal replacement therapy, and renal death.[15, 16] In patients with T2DM, GLP-1RAs significantly reduced CRO incidence, primarily driven by an 18% reduction in new-onset macroalbuminuria.[47] More recently, the FLOW trial, a dedicated kidney outcome trial in patients with T2DM and CKD, was terminated early due to overwhelming efficacy and mortality benefit.[24] FLOW revealed that semaglutide reduced the risk of a composite kidney outcome by 24% compared to placebo.[24] Emerging data suggest GLP-1RAs may also offer kidney benefits in populations without diabetes.[48] The SELECT trial demonstrated a reduced risk of persistent eGFR decline in patients with obesity and cardiovascular disease treated with semaglutide.[15] Additionally, a meta-analysis of placebo-controlled RCTs reported a slower decline in eGFR over one year in individuals with a baseline eGFR 3060 mL/min/1.73m 2 treated with GLP-1RAs regardless of diabetes status.[12] These findings support the potential utility of GLP-1RAs in CKD patients without diabetes, and additional dedicated trials are underway to validate these outcomes in populations without diabetes
Jed Kaminetsky, a urologist involved in the trial, have voiced optimism: I have used bremelanotide in my practice for men with ED The combination of bremelanotide with a PDE5i could potentially be an effective treatment option for PDE5i non-responders
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For all GLP-1 receptor agonists, discontinuation is advised upon recognition of pregnancy
Association of Aspirin Use with Vitamin B12 Deficiency (Results of the BACH Study) Am
Signaling pathways of ferroptosis and associated neurological diseases
