For years, GLP-1's cardiovascular benefits were well-established. But 2024 brought a watershed moment: the FLOW trial demonstrated that semaglutide significantly reduces kidney disease progression — a finding that is reshaping how nephrologists think about treatment.
The FLOW trial enrolled 3,533 people with type 2 diabetes and chronic kidney disease (CKD). Semaglutide 1mg reduced the primary kidney endpoint (worsening kidney function, kidney failure, or kidney/cardiovascular death) by 24% compared to placebo. The trial was stopped early because the benefits were so clear.
Current evidence is strongest for people with type 2 diabetes and CKD. Research in people with CKD without diabetes is ongoing. If you have any degree of kidney disease or elevated creatinine, this class of medication deserves serious discussion with your nephrologist.
GLP-1 medications are generally safe in CKD without dose adjustment (unlike metformin). However, GI side effects can worsen dehydration, which stresses kidneys — stay well-hydrated and monitor kidney function markers with your doctor.
Getting 100g+ of protein daily on a reduced appetite is hard. Strategic timing makes it more achievable — and more effective for muscle preservation.
Medication helps with appetite. But the mental skills for sustainable weight management — resilience, flexibility, self-compassion — must be built intentionally.
People who share their journey with a community — online or in person — consistently achieve better outcomes. Here's why, and where to find yours.