Bridging the Gap to Waitlist Activation: Semaglutide's Weight Loss Efficacy and Safety in Patients With Obesity on Dialysis Seeking Kidney Transplantation.
Francis G Wade, Krista L Lentine, David Turk, Kyleigh Kirbach, Taylor Knobloch, Mark Schnitzler, Kamran Qureshi, Wing-Kin Syn, Vidya A Fleetwood
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Abstract
Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated efficacy for weight loss and glycemic control in patients with obesity and type 2 diabetes mellitus, but data are limited for patients with end-stage kidney disease on dialysis. We examined the weight loss efficacy and safety of semaglutide when prescribed to patients on dialysis to improve transplant candidacy and activation status. We conducted a retrospective chart review of 36 patients on dialysis who were prescribed semaglutide through a metabolic clinic between September 2021 and December 2023. Outcomes included weight loss efficacy, safety, and change in waitlist status at 1 year. Patients achieved a mean total body weight loss of 7.8% (SD 6.1). Of patients who were ineligible for transplant due to elevated body mass index, 48.2% achieved waitlist activation after successful weight loss. Treatment-limiting gastrointestinal side effects occurred in 16.7% of patients. Patients on peritoneal dialysis (PD, 30.8%) versus hemodialysis (8.7%) discontinued therapy more frequently. In a single-center cohort, patients who received semaglutide experienced significantly greater weight loss and increased rates of waitlist activation compared with a lifestyle-only intervention. Semaglutide was generally well-tolerated. Prospective studies should examine whether patients on PD experience severe GI side effects more frequently on semaglutide.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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