Researchers report that the key ingredient in Ozempic, semaglutide, may repair damaged blood vessels in the kidneys and improve how the organ filters waste.
The weight-loss drug appears to restore and repair blood vessels that support kidney function, according to findings published in Nature Medicine. The researchers said the results add another potential health benefit to semaglutide, while also suggesting a possible role in treating chronic kidney disease.
In patients with the condition, semaglutide was associated with increased blood flow and reduced inflammation, the research team reported. The study adds to the known anti-inflammatory effects of the GLP-1 drug while pointing to a possible direct protective effect on the kidney’s blood vessels, said Susan Quaggin, a nephrologist at Northwestern University Feinberg School of Medicine in Chicago who was not involved in the work.
Chronic kidney disease affects an estimated 674 million people worldwide, and diabetes and high blood pressure are among the most common causes. As the disease progresses, the kidneys gradually lose their ability to filter waste from the blood and remove it through urine, leading to additional health complications and a higher risk of death from heart attack or stroke.
In patients with diabetic chronic kidney disease who took semaglutide, the drug was linked to a lower likelihood of progressing to kidney failure or dying from heart attack or stroke than those who took a placebo, researchers reported in 2024 in the New England Journal of Medicine. That trial was stopped early because the drug was so effective at preventing death that researchers said it was no longer ethical to continue giving participants a placebo.
For the newer study, researchers examined a subset of 106 participants to better understand how semaglutide worked. The team compared kidney tissue samples taken before and after treatment with samples from participants who received a placebo. Semaglutide use was associated with visible changes in the tissues, including increased blood flow, reduced scarring and reduced blood vessel stiffness.
Increased blood flow is important because it supports filtration, the main function of the kidneys, said Peter Nguyen, a nephrologist at Houston Methodist Hospital who was not involved in the study.
The researchers also looked at levels of a protein called albumin in patients’ urine. Higher levels can be an early sign that the kidneys’ filters are not working properly. While levels did not change much in those given a placebo, they decreased in patients taking semaglutide, suggesting the filters were less leaky.
The team then examined genetic clues that may explain how semaglutide appeared to help the kidneys. Within the glomerulus, the tiny blood vessels responsible for filtering, researchers found that genes related to metabolic stress were turned off. In the same cells, inflammatory genes were also turned off, while repair genes were switched on.
The researchers also looked at a subset of genes involved in how cells communicate within the glomerulus. Before semaglutide, the blood vessels and immune cells appeared to be signaling to one another, producing inflammatory signals, said Katherine Tuttle, a nephrologist at the University of Washington’s Providence Medical Research Center in Spokane, and colleagues. After semaglutide, the immune cells quieted, silencing messages that can drive harmful inflammation. These changes in gene activity suggest a healthier kidney that is less stressed and inflamed, and that has repair processes activated.
With semaglutide treatment, Tuttle said, patients’ damaged kidneys showed clear signs of repair.