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Research Summary
Analyzed using Evidence Intelligence™

Semaglutide reduces cardiovascular risks in type 2 diabetes with CKD

Powered by the Dediabetes Evidence Intelligence™ framework

Last updated July 6, 2026

Key finding

Semaglutide reduced CV death/MI/stroke by 18% [hazard ratio (HR) 0.82 (95% confidence interval 0.68–0.98); P = .03]

The FLOW trial investigated the effects of semaglutide on cardiovascular outcomes in patients with type 2 diabetes and chronic kidney disease, revealing significant reductions in cardiovascular death, myocardial infarction, and stroke.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

The FLOW trial investigated the effects of semaglutide on cardiovascular outcomes in patients with type 2 diabetes and chronic kidney disease, revealing significant reductions in cardiovascular death, myocardial infarction, and stroke.

Clinical relevance

The findings from the FLOW trial are clinically significant as they highlight the potential of semaglutide to improve cardiovascular outcomes in a vulnerable population. Patients with type 2 diabetes and chronic kidney disease are at increased risk for cardiovascular events, and effective interventions like semaglutide could lead to better health outcomes and reduced mortality rates in this group.

Keep in mind

The study's effectiveness data were unclear for some outcomes. Results may not be generalizable to populations outside the trial. Potential unmeasured confounders may affect the outcomes. The trial design may limit long-term outcome assessments.

Published in

Journal Reference

Publication details and source links for this paper.

Kenneth WM, Katherine RT, Mustafa A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Chronic Kidney Disease: Results from the FLOW Trial. European Heart Journal. 2025;46(12):1096-1108. doi:10.1093/eurheartj/ehae613

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Main Effects

Semaglutide reduced the composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke by 18% (HR 0.82, p = 0.03).

All-cause mortality was reduced by 20% with semaglutide (HR 0.80, p = 0.01).

No significant difference was observed in the composite outcome between groups (p = 0.03).

No significant difference was found in all-cause mortality between groups (p = 0.01).

Evidence network

How this study fits

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Evidence Context

This study contributes evidence to Semaglutide and All-cause mortality, Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke.

This study contributes evidence to

Intervention

Semaglutide

Outcome

All-cause mortality

Evidence topic

Cardiovascular Risk

Primary intervention

Semaglutide

Primary outcomes

  • All-cause mortality
  • Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Evidence topics

Cardiovascular RiskGLP-1 Receptor Agonists

Primary intervention

Semaglutide

Primary outcomes

All-cause mortalityComposite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

2
Evidence pairs
2
Relationships
2
Evidence topics
contributes_evidence

Editorial context

Why this study matters

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Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 60

2

Related topics

2

Evidence pairs

124

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 2 evidence relationships
  • Includes primary outcome data
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

GLP-1 Receptor Agonists and Cardiovascular Outcomes

Related evidence

Evidence topic

Cardiovascular Risk

Save evidence

Evidence topic

GLP-1 Receptor Agonists

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Core evidence

Study findings

The primary outcomes reported in this study.

All-cause mortality

Semaglutide → All-cause mortality

Semaglutide → All-cause mortality

Evidence Intelligence™
EvidenceScore™
82
Strong
ImpactScore™
64
Slightly Positive
ConsistencyScore™
57
generally_consistent
Supporting studies: Based on 7 studies
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Evidence Library

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evidence suggest

Evidence Suggest

  • Semaglutide significantly reduced cardiovascular events by 18% (HR 0.82).
  • All-cause mortality was reduced by 20% (HR 0.80).
  • No significant differences were found for some outcomes.
who this applies

Who this applies to

  • Adults with type 2 diabetes.
  • Patients with chronic kidney disease.
  • Individuals at high risk for cardiovascular events.
keep in mind

Keep in Mind

  • Results are based on a specific population and may not apply to all patients.
  • The study's design may have limitations affecting the interpretation of results.
  • Further research is needed to confirm long-term benefits and safety.
between the lines

Between the Lines

  • The study's effectiveness data were unclear for some outcomes.
  • Results may not be generalizable to populations outside the trial.
  • Potential unmeasured confounders may affect the outcomes.
  • The trial design may limit long-term outcome assessments.

Evidence Library

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Connected Evidence

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Relationships organized using the Dediabetes Evidence Intelligence™ framework.

Powered by the Dediabetes Evidence Intelligence™ framework

This study contributes to evidence on GLP-1 Receptor Agonists and Cardiovascular Outcomes, GLP-1 Receptor Agonists and Cardiovascular Outcomes.

Related evidence relationships

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This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Do GLP-1 Receptor Agonists improve cardiovascular outcomes?

Strong Evidence

GLP-1 Receptor Agonists may improve cardiovascular outcomes.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    All-cause mortality

    EvidenceScore™ Strong | EvidenceScore™ 82.3 | weak positive | ConsistencyScore™ Generally Consistent | 1 study

  2. 2

    Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study

Why this answer: This answer is based on 13 supporting studies with consistent results and a positive effect signal.

13 supporting studies
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Next steps

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Evidence topics

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Cardiovascular Risk Evidence HubGLP-1 Receptor Agonists Evidence Hub

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All studies on Semaglutide and All-cause mortalityAll studies on Semaglutide and Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Related research

Read related research summaries.

Semaglutide may reduce cardiovascular events in non-diabetic patients.Oral semaglutide reduces cardiovascular events in type 2 diabetesSemaglutide improves insulin sensitivity in adolescents with obesityHigher semaglutide doses improve glucose control in type 2 diabetesNovel Semaglutide Injection Shows Non-Inferior Glycemic Control

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