The FLOW of Progress in Diabetic Kidney Disease: Semaglutide’s Role in Combination Therapy

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease globally, with its prevalence mirroring that of the worldwide diabetes epidemic. Less appreciated is that DKD also carries a markedly increased risk of cardiovascular morbidity and mortality ( 1 ). Chronic kidney disease (CKD) staging, based on albuminuria and estimated glomerular filtration rate (eGFR), powerfully predicts adverse kidney and cardiovascular outcomes ( 2 ). Even with optimal control of traditional cardiovascular risk factors, people with CKD face persistent and substantial residual risk for cardiovascular and kidney disease progression ( 3 ). The American Heart Association and American Diabetes Association highlight the need for risk reduction strategies targeting lifestyle, glycemia, blood pressure, lipids, and kidney disease–specific factors in the context of cardiovascular-kidney-metabolic syndrome ( 1 ).