{"id":"e1def28e5f4a","type":"article","url":"https://hartvaat.nl/2025/03/24/flow-semaglutide-cv-voordelen-naar-ckd-ernst-bij-diabetes/","title":"FLOW: semaglutide CV-voordelen naar CKD-ernst bij diabetes","title_en":"Cardiovascular outcomes with semaglutide by severity of chronic kidney disease in type 2 diabetes: the FLOW trial.","category":"preventie","category_label":"Preventie","professions":["cardioloog","internist"],"tags":["anemie-ckd","cardiorenal-behandelstrategie","chronische-nierziekte","cystatine-c","diabetes-en-hart","fidelio-dkd","flow-trial","ijzertekort","select-trial","soul-trial","stride-trial"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehae613","source_url":"https://doi.org/10.1093/eurheartj/ehae613","authors":["Kenneth W Mahaffey","Katherine R Tuttle","Mustafa Arici","Florian M M Baeres","George Bakris","David M Charytan","David Z I Cherney","Gil Chernin","Ricardo Correa-Rotter","Janusz Gumprecht","Thomas Idorn","Giuseppe Pugliese","Ida Kirstine Bull Rasmussen","Søren Rasmussen","Peter Rossing","Ekaterina Sokareva","Johannes F E Mann","Vlado Perkovic","Richard Pratley"],"significance":7,"published":"2025-03-24","source_date":"2025-03-24","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/bempedoïnezuur/"],"congress":"","summary_en":"This FLOW subanalysis confirmed that semaglutide's cardiovascular benefit is consistent across CKD severity stages in type 2 diabetes, with the greatest absolute benefit in patients with more advanced kidney disease.","created":"2026-07-03T10:31:31Z","updated":"2026-07-03T13:30:32Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"FLOW-subanalyse toonde dat het CV-voordeel van semaglutide consistent is over CKD-ernst bij diabetes. Patiënten met ernstiger CKD hadden grotere absolute risicoreductie.","abstract_original":"BACKGROUND AND AIMS: In the FLOW trial, semaglutide reduced the risks of kidney and cardiovascular (CV) outcomes and death in participants with type 2 diabetes and chronic kidney disease (CKD). These prespecified analyses assessed the effects of semaglutide on CV outcomes and death by CKD severity. METHODS: Participants were randomized to subcutaneous semaglutide 1 mg or placebo weekly. The main outcome was a composite of CV death, non-fatal myocardial infarction (MI), or non-fatal stroke (CV death/MI/stroke) as well as death due to any cause by baseline CKD severity. CKD was categorized by estimated glomerular filtration rate < or ≥60 mL/min/1.73 m2, urine albumin-to-creatinine ratio < or ≥300 mg/g, or Kidney Disease Improving Global Outcomes (KDIGO) risk classification. RESULTS: Three thousand, five hundred and thirty-three participants were randomized with a median follow-up of 3.4 years. Low/moderate KDIGO risk was present in 242 (6.8%), while 878 (24.9%) had high and 2412 (68.3%) had very high KDIGO risk. Semaglutide reduced CV death/MI/stroke by 18% [hazard ratio (HR) 0.82 (95% confidence interval 0.68-0.98); P = .03], with consistency across estimated glomerular filtration rate categories, urine albumin-to-creatinine ratio levels, and KDIGO risk classification (all P-interaction > .13). Death due to any cause was reduced by 20% [HR 0.80 (0.67-0.95); P = .01], with consistency across estimated glomerular filtration rate categories and KDIGO risk class (P-interaction .21 and .23, respectively). The P-interaction treatment effect for death due to any cause by urine albumin-to-creatinine ratio was .01 [<300 mg/g HR 1.17 (0.83-1.65); ≥300 mg/g HR 0.70 (0.57-0.85)]. CONCLUSIONS: Semaglutide significantly reduced the risk of CV death/MI/stroke regardless of baseline CKD severity in participants with type 2 diabetes."}