Short-term clinical efficacy and recorded adverse events of semaglutide combined with dapagliflozin in patients with type 2 diabetes mellitus and chronic kidney disease

Type 2 diabetes mellitus (T2DM) complicated by chronic kidney disease (CKD) is associated with persistent hyperglycemia, progressive renal impairment, systemic inflammation, and an increased risk of adverse clinical outcomes. Sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists have shown metabolic and cardiorenal benefits, but clinical evidence regarding their combined use in patients with T2DM and CKD remains limited. This retrospective observational study included 126 patients with T2DM complicated by CKD who were treated at our hospital between March 2023 and July 2024. Patients were identified through a review of electronic medical records and the application of predefined eligibility criteria. Treatment groups reflected the actual regimen documented in the medical record rather than random allocation. The final analytic cohort comprised 42 patients in each group; the equal group size reflected the eligible records with complete baseline and 8-week follow-up data available in each treatment category during the study period rather than a prospective 1:1:1 enrollment target. The treatment duration was 8 weeks. Glycemic indices, renal function-related parameters, inflammatory markers, clinical response, and recorded adverse events were compared among the 3 groups. After 8 weeks of treatment, fasting plasma glucose, 2-hour postprandial plasma glucose, hemoglobin A1c, blood urea nitrogen, serum creatinine, 24-hour urinary protein, erythrocyte sedimentation rate, interleukin-6, and high-sensitivity C-reactive protein were significantly reduced in all 3 groups compared with baseline. The combination group showed greater short-term reductions in glycemic indices, renal function-related parameters, and inflammatory markers than either monotherapy group. The overall clinical response rate was significantly higher in the combination group than in the dapagliflozin or semaglutide group. In patients with T2DM complicated by CKD, semaglutide combined with dapagliflozin was associated with greater short-term improvements in glycemic control, inflammatory markers, and renal function-related indicators, as well as a higher exploratory clinical response rate, than either monotherapy. No increase in recorded adverse events was detected during 8 weeks of treatment. Because of the retrospective design, modest sample size, and short observation period, these findings should not be interpreted as demonstrating definitive long-term renal benefit or equivalent long-term safety. Further large-scale prospective studies with standardized renal outcomes are required.