The takeaway
A planned SELECT analysis found fewer combined kidney-related events with semaglutide. That does not mean every participant's kidneys improved.
Who was studied?
SELECT included 17,604 adults aged 45 or older with overweight or obesity and existing cardiovascular disease, without diabetes. Median follow-up was 182 weeks.
Percent of participants; composite outcome, not kidney death or dialysis alone
Original visual based on the study.
| Group or measure | Result |
|---|---|
| Semaglutide 2.4 mg weekly | 1.8% |
| Placebo | 2.2% |
What changed?
The combined outcome occurred in 1.8% with semaglutide versus 2.2% with placebo—a 0.4-percentage-point difference. It grouped kidney death, dialysis/transplantation, major persistent filtration declines and persistently high urine protein.
The difference mainly reflected urine-protein and filtration outcomes. The rarer components cannot establish a separate reduction in kidney deaths or dialysis.
The trade-offs
Adverse events caused permanent treatment stopping in 16.6% versus 8.2%, mostly digestive problems. This was a secondary analysis with relatively few kidney events and no adjustment for multiple testing; it does not tell us the effect in otherwise healthy adults.
Novo Nordisk funded SELECT. See the main SELECT summary for its heart outcomes.