ingrid_STO said:Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.
Genuinely useful, thank you. I had the facts and not the framework. Sending this to two other people who asked me the same thing last week.
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 | 82 | 95 | >60 |
| Creatinine | 1.2 | 0.9 | 0.7-1.3 |
| BUN | 24 | 16 | 7-20 |
| UACR | 67 | 20 | <30 |
The FLOW trial demonstrated renal protective effects of semaglutide. My nephrologist is encouraged by the UACR improvement especially.
hans_munich said:Steady state is the thing most people miss.
Pushing back on hans_munich here. 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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Browse GL BiochemDr.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…
The FLOW trial results on renal function and renal outcomes: semaglutide 1.0mg reduced the composite kidney outcome by 24% (HR 0.76, p=0.0003) in CKD patients with T2DM[1].
The trial was stopped early for efficacy — always a strong signal. GFR decline was 1.16 mL/min/1.73m²/year slower with semaglutide. This positions GLP-1 agonists alongside SGLT2 inhibitors as pillars of cardiorenal protection in T2DM.
[1] Perkovic V, et al. N Engl J Med. 2024.
Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Report rather than reply if it drifts again.