# FLOW: semaglutide CV-voordelen naar CKD-ernst bij diabetes

*geplaatst 2025-03-24 · Preventie · European heart journal · doi 10.1093/eurheartj/ehae613 · https://hartvaat.nl/2025/03/24/flow-semaglutide-cv-voordelen-naar-ckd-ernst-bij-diabetes/*

FLOW-subanalyse toonde dat het CV-voordeel van semaglutide consistent is over CKD-ernst bij diabetes. Patiënten met ernstiger CKD hadden grotere absolute risicoreductie.

## English: Cardiovascular outcomes with semaglutide by severity of chronic kidney disease in type 2 diabetes: the FLOW trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehae613. Bijgewerkt 2026-07-03T13:30:32Z. 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.