Dr.PulmRoch said:Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.
Thank you — that is the clearest version of this I have read, and I have read a lot of them.
Clinical perspective, offered as context rather than as advice.
Kidney function labs on renal function — good news for anyone concerned about renal effects:
| Marker | Baseline | Month 6 | Ref Range |
|---|---|---|---|
| eGFR | 77 | 96 | >60 |
| Creatinine | 1.3 | 1.0 | 0.7-1.3 |
| BUN | 25 | 16 | 7-20 |
| UACR | 62 | 25 | <30 |
The FLOW trial demonstrated renal protective effects of semaglutide. My nephrologist is encouraged by the UACR improvement especially.
sophie_paris said:Steady state is the thing most people miss.
This is where I part company with the consensus forming above. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.
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Shop Reference StandardsDr.RenalNash said:FLOW is the relevant trial and it reported a meaningful reduction in kidney-disease progression and related death in people with type 2 diabetes and…
GFR trending upward on renal function — encouraging for those with mild CKD concerns:
Baseline eGFR: 68 → Month 6: 84 → Month 12: 90
The FLOW trial confirmed renal benefits of semaglutide: 24% reduction in kidney disease progression. My nephrologist is now actively recommending GLP-1 therapy for appropriate CKD patients. This could be a paradigm shift in nephrology.