GLP-1 evidence signals shift in future dialysis care in US, says GlobalData
Emerging evidence that GLP-1 therapies can slow chronic kidney disease (CKD) progression is reshaping expectations for renal care demand in the US. As semaglutide demonstrates measurable reductions in kidney decline, cardiovascular events, and mortality, clinicians and device manufacturers face a pivotal inflection point, balancing delayed disease progression with the likelihood of more patients ultimately surviving long enough to require dialysis and transplant support, says GlobalData, a leading data and analytics company.
Reportedly, around 14% of US adults had CKD between 2017 and 2020, and more than 815,000 people are living with end-stage renal disease (ESRD). Comorbidity is common, in 2022, 59% of ESRD patients had diabetes, 25% had heart failure, and 20% had other cardiac disease.
Selena Yu, Senior Medical Analyst at GlobalData, comments: “GLP-1s, like Ozempic (semaglutide) used for diabetes remission could ultimately reduce new CKD cases, but uncertain long-term population effects and access limitations (e.g., payer coverage) mean both clinicians and medical device companies must plan for mixed scenarios in service demand and patient access.”
A 2024 clinical trial, “A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney Disease,” found that the decline in kidney function was slower in the semaglutide group compared to the placebo group, and patients on semaglutide risk of major cardiovascular evens was 18% lower and risk of death caused by them was 20% lower.
In turn, the FDA approved Ozempic for use in reducing the risk of kidney failure and disease progression, and heart problems associated with diabetes patients with CKD in January 2025. And the European Medicines agency also added use case of reduction for events related to kidney disease to the label of Ozempic. Although, Ozempic is not curative, it can slow the progression to ESRD, decrease major cardiovascular events and deaths associated with them, thus improving the patient’s journey.
Yu adds: “One thing to note is more patients with CKD are surviving to stage 5 or ESRD. This is because Ozempic will not cure CKD, it functionally works as slowing down the disease progression but eventually patients will develop ESRD as kidney function declines. Therefore, more patients will need transplants and dialysis since they are surviving longer in earlier stages of CKD to reach ESRD. Thus, there may be a rise in the medical devices from HLA testing for organ matching to dialyzers and dialysis machines for dialysis care.
“On the other hand, because type 2 diabetes is a leading cause of CKD, broader use of GLP-1 agonists before kidney impairment begins could potentially reduce future ESRD prevalence. With one in three adults with diabetes developing CKD, achieving diabetes remission through agents like semaglutide may prevent a significant share of these patients from progressing to kidney disease at all.”
Currently, it is difficult to predict the market dynamics for dialysis care in the US with Ozempic’s clinical applications still being tested in clinical trials. Moreover, with budget cuts to public services like Medicare and Medicaid, patients with CKD who would benefit from treatment with GLP-1 agonists may have limited access to care.
Yu concludes: “Semaglutide has been shown to slow CKD progression, reduce major cardiovascular events, and lower cardiovascular mortality in people with type 2 diabetes and CKD, prompting regulatory label expansions for kidney- and heart-protection. Because semaglutide delays but does not cure kidney disease, clinicians should anticipate patients living longer with earlier-stage CKD yet still progressing to ESRD which requires proactive care coordination, earlier transplant and dialysis planning, and aggressive management of comorbidities. On the other hand, industry may see increased demand for dialysis equipment and transplant-related services.”
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Notes to Editors
- Quotes provided by Selena Yu, Senior Medical Analyst at GlobalData
- This press release was written using data and information sourced from proprietary databases, primary and secondary research, and in-house analysis conducted by GlobalData’s team of industry experts
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