Researchers studied whether a weight loss medication called semaglutide could help people on kidney dialysis lose weight and become eligible for transplants. In this study of 36 patients, nearly half of those who were too heavy to receive a transplant successfully lost enough weight to get on the transplant waiting list. The medication worked well for most people, though some experienced stomach problems. This research suggests that semaglutide might be a useful tool to help dialysis patients achieve their goal of getting a new kidney, though more research is needed to confirm these results.

The Quick Take

  • What they studied: Can a weight loss medication help people on kidney dialysis lose enough weight to qualify for kidney transplants?
  • Who participated: 36 patients who were on dialysis (a treatment that filters waste from the blood when kidneys don’t work) and were prescribed semaglutide at a medical clinic between 2021 and 2023
  • Key finding: Patients lost an average of 7.8% of their body weight, and nearly half of those who were initially too heavy for a transplant became eligible for the transplant waiting list after taking the medication
  • What it means for you: If you’re on dialysis and overweight, this medication may help you lose weight and become a candidate for a kidney transplant. However, this is early research from one hospital, so talk with your doctor about whether it’s right for you.

The Research Details

Researchers looked back at medical records from 36 patients who received semaglutide (a medication that helps with weight loss) at one hospital’s metabolic clinic over about two years. They tracked how much weight each patient lost, whether they experienced side effects, and whether they became eligible for kidney transplants. This type of study is called a retrospective review because doctors examined records from the past rather than following patients forward in time. The researchers also compared these results to patients who only tried lifestyle changes like diet and exercise.

This research approach is important because it shows real-world results from actual patients in a hospital setting. While this type of study can’t prove cause-and-effect as strongly as a controlled experiment, it provides valuable information about whether a medication works in practice and is safe for this specific group of patients.

This study has some important limitations to consider: it’s small (only 36 patients), it only looked at one hospital, and it reviewed past records rather than carefully tracking patients over time. The results are promising but should be confirmed with larger, more rigorous studies before making major treatment decisions. The fact that nearly half of eligible patients achieved transplant activation is encouraging, but individual results may vary.

What the Results Show

Patients taking semaglutide lost an average of 7.8% of their body weight over the study period. This may not sound like a lot, but for people on dialysis trying to qualify for transplants, it was enough to make a real difference: nearly half (48.2%) of patients who were initially ineligible for transplants due to being overweight became eligible for the transplant waiting list after their weight loss. When compared to patients who only tried lifestyle changes, the semaglutide group lost significantly more weight and had better success rates for transplant eligibility. Most patients tolerated the medication reasonably well, suggesting it’s generally safe for this population.

One important finding was that patients on peritoneal dialysis (a type of dialysis done at home) were more likely to stop taking the medication due to stomach problems compared to patients on hemodialysis (dialysis done at a clinic). Specifically, 30.8% of peritoneal dialysis patients stopped the medication versus only 8.7% of hemodialysis patients. Overall, stomach-related side effects that made patients stop treatment occurred in 16.7% of all patients. This suggests the medication may be harder to tolerate for certain dialysis patients.

Semaglutide has been well-studied in people with obesity and diabetes, where it consistently produces weight loss of 10-15%. This study shows similar weight loss results in dialysis patients, which is encouraging. However, dialysis patients are a special population with unique health challenges, so it’s important to study them separately. The finding that nearly half of ineligible patients became transplant-eligible is particularly significant because it suggests the medication could help achieve an important health goal for this group.

This study is relatively small with only 36 patients from one hospital, so results may not apply to all dialysis patients everywhere. Because researchers looked at past medical records rather than carefully tracking patients forward in time, they couldn’t control for all factors that might affect weight loss. The study didn’t include a randomized control group (where some patients randomly receive the medication and others don’t), which would provide stronger evidence. Additionally, the study period was relatively short, so we don’t know if weight loss is maintained long-term or if transplant patients do well after receiving their new kidney.

The Bottom Line

If you’re on dialysis and overweight, semaglutide may be worth discussing with your transplant team and nephrologist (kidney doctor). The evidence suggests it can help with weight loss and transplant eligibility, though this is early research. This is a moderate-confidence recommendation based on one hospital’s experience. Your doctor should monitor you closely for stomach side effects, especially if you’re on peritoneal dialysis. This medication should only be used under medical supervision.

This research is most relevant for people on dialysis who want a kidney transplant but are currently ineligible due to excess weight. It may also interest transplant programs looking for ways to help more patients become transplant candidates. People on hemodialysis may tolerate this medication better than those on peritoneal dialysis. This research is not directly applicable to people with normal kidney function or those not seeking transplants.

In this study, patients achieved meaningful weight loss over several months to a year. However, individual results vary. Some patients may see benefits within 2-3 months, while others may take longer. It’s important to have realistic expectations: this medication helps with weight loss, but it’s not a quick fix. Most patients in the study who became transplant-eligible did so within the first year of treatment.

Want to Apply This Research?

  • Track weekly weight and waist circumference measurements, plus a simple 1-10 scale for stomach symptoms (nausea, vomiting, appetite changes). Record any changes in transplant eligibility status or waitlist activation.
  • Use the app to set a specific weight loss goal with your doctor (for example, losing 5-10% of body weight), log daily medication adherence, and record any side effects immediately so you can discuss them with your healthcare team at appointments.
  • Create a monthly review where you check weight trends, side effect patterns, and transplant eligibility updates. Share this data with your nephrologist and transplant team to help them monitor your progress and adjust treatment if needed. Set reminders for regular lab work and clinic visits.

This research describes early findings from one hospital’s experience with semaglutide in dialysis patients. These results are promising but should not replace personalized medical advice from your nephrologist or transplant team. Semaglutide is a prescription medication with potential side effects and should only be used under close medical supervision. Individual results vary significantly. If you’re on dialysis and interested in this medication, discuss it with your healthcare providers who understand your complete medical situation. This summary is for educational purposes and does not constitute medical advice.