​In recent years, several new medicines have emerged that offer hope of effectively tackling chronic kidney disease, which affects around 10 per cent of the adult population.

The latest addition is Ozempic. The medication has now been shown to benefit the kidneys as well – not only weight, blood glucose regulation and cardiovascular disease. This is demonstrated by the FLOW study, which was presented on 24 May at the ERA (European Renal Association) congress and published in the prestigious scientific journal New England Journal of Medicine.

Chief Physician and Head of Research at Steno Diabetes Center Copenhagen (SDCC), Peter Rossing – who is also Professor of Clinical Medicine at the University of Copenhagen – helped present the Novo Nordisk study in Stockholm. He is first author of the study design. The trial was stopped in October 2023 because the results were so convincing that it would have been unethical to continue.

At the ERA congress in Stockholm, Peter Rossing helped present the results of the compelling study.

“This is an unusual study because the conclusions are so clear. It is also the first time we have seen that this type of diabetes medication – GLP-1 receptor agonists such as Ozempic – has a protective effect on kidney function. We already knew that Ozempic has benefits for blood glucose regulation, weight loss and cardiovascular disease. We now have medicines that can do an extraordinary number of things – that is fantastic," says Peter Rossing, pointing to the prospect of having even more effective treatment options available for people with kidney disease and for people with diabetes and kidney complications.

Other medicines that have emerged in recent years include SGLT-2 inhibitors and the drug finerenone. SGLT-2 inhibitors lower blood glucose and have beneficial effects on both cardiovascular disease and kidney disease. Finerenone likewise has a protective effect on kidney function and reduces the incidence of cardiovascular disease in people with type 2 diabetes and kidney disease.

The challen​ge: Who should receive which medication?

As an internationally recognised researcher and endocrinologist, Peter Rossing helps ensure that new knowledge is translated into improved treatment. He contributes to clinical guidelines in the field and serves as Chair of the Danish Diabetes Database, where he can monitor prescribing patterns.

“We now need to determine how the individual medicines should be used and who should receive them. We do not know whether everyone should receive the same medication as a package solution. That would be costly and perhaps not appropriate. We want individualised solutions and are increasingly working towards identifying the right medicine for the right patient. That is the challenge now. But it is tremendously encouraging that we have more and more options to try to prevent people from developing severe kidney disease. We are moving closer and closer to being able to say that kidney disease can largely be eradicated," says Peter Rossing, who also leads complications research at SDCC.

FLOW is the first kidney outcomes study with semaglutide for people with type 2 diabetes. The effect of semaglutide (the active substance in Ozempic) in people without type 2 diabetes but with overweight and cardiovascular disease is being investigated in other, smaller studies.