Case report of the successful use of semaglutide to achieve target BMI prior to renal transplant in two patients with end‐stage‐kidney‐disease

Abstract The following cases demonstrate a proof of concept for the safe and effective use of the glucagon‐like‐peptide‐1 receptor agonist (GLP‐1 RA) semaglutide for weight loss in obese, non‐diabetic, end stage kidney disease (ESKD) patients on haemodialysis (HD), who are unable to undergo renal transplantation due to obesity. Obesity is a common barrier to wait‐listing for renal transplantation with effective, broadly applicable weight loss strategies lacking. GLP‐1 RAs have been shown to be effective adjuncts to achieve weight loss in non‐diabetic obese people. However, the major clinical trials excluded patients with ESKD on dialysis. This paper outlines the successful use of semaglutide to achieve a target body mass index (BMI) prior to renal transplant wait‐listing in two obese, non‐diabetic, HD patients. These patients achieved a 16% and 12.6% weight loss in under 9 months with one now waitlisted and the other transplanted. This strategy has the potential for broader use in this patient cohort to improve wait‐list times by overcoming this common barrier to renal transplantation.