Adding my data. Not T2D, just obese with early CKD2. Tirzepatide 7.5 mg, 6 months: | Marker | Baseline | Month 6 | |--------|----------|---------| | eGFR | 72 mL/min | 78 mL/min | | UACR | 42 mg/g | 18 mg/g | | Creatinine | 1.08 mg/dL | 0.98 mg/dL | | Uric Acid | 8.2 mg/dL | 6.1 mg/dL | The UACR normalization is great, but I'm also really happy about the uric acid drop. Hyperuricemia is independently nephrotoxic and contributes to CKD progression. GLP-1 RAs appear to lower uric acid through increased renal excretion.

Morris, great point about uric acid. It's an underappreciated marker in kidney disease. The GLP-1 effect on uric acid is partly mediated by improved insulin sensitivity (insulin promotes uric acid reabsorption in the proximal tubule) and partly by natriuresis. Your UACR going from 42 to 18 — normal is <30, so you've gone from microalbuminuria to normal range. That's clinically meaningful CKD regression.

Update: Showed this thread (and the FLOW trial paper) to my nephrologist. She's agreed to start me on semaglutide 0.25 mg with extra monitoring — labs every 4 weeks for the first 3 months. She also wants me to track daily fluid intake and weight. Starting next week!

Yes Ron!! 🎉 The extra monitoring is smart and shows your nephrologist is being appropriately cautious while still being open to the evidence. Please come back and share your labs — we're rooting for you. Stay hydrated and be patient with the titration. This is a marathon, not a sprint.